Parent's Night Out Registration
Paxtonville United Methodist Church is hosting a Parent's Night Out on December 6th, 2019 from 6:00 to 9:00PM. The church address is 1281 Paxton Street, Paxtonville, PA 17861.

Our goal is to bless local families and parents by offering a time when parents may leave their children with our volunteers, giving parents time to finish up something on the holiday to-do list, or time to just relax.

For the children who come, we have a number of activities planned. We will have a snack (no dinner will be served, so please have your child eat before coming), do some Christmas songs, games, have a Christmas story, some crafts, and conclude the evening by watching "The Star" movie about the birth of Jesus. Parents who register may bring and pick up their child(ren) any time within the 6:00 to 9:00PM time frame

Please fill out the following form to register your child for PUMC Parent's Night Out. All registrations must be received by Tuesday December 3rd. No children will be allowed in the event unless they pre-register (this is for our safety, your safety, and to ensure we have enough volunteers with clearances to care for your family).
Child's Name *
Your answer
Child's Gender
Child's Age *
Your answer
Date of Birth
MM
/
DD
/
YYYY
Last School Grade Completed *
Your answer
Name of Parent(s) *
Your answer
Street Address
Your answer
Mailing Address (if different)
Your answer
Parent/Caregiver Phone Number *
Your answer
Parent/Caregiver E-mail
Your answer
Home Church/Affiliation
Your answer
Allergies and/or Other Medical Concerns *
Your answer
Emergency Contact Person/Relation to Child *
Your answer
Names of Persons Permitted to Pick Up Child When Event Is Over: *
Your answer
Submit
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