Registration Form
Cornerstone Church
41w170 Russell Road, Elgin, IL 60124
Church Office: (847) 464-4673
Email address *
Parents' Day Out 2017
Enjoy a day of child-free shopping while your kids enjoy a fun morning of Christmas crafts, games, movies, and lunch. $5 per child fee will help offset the cost of lunch and craft supplies.

Time: 9am-2pm

Parent's Name *
Your answer
Parent's Phone *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
Child #1: Name and Age *
Your answer
Child #2: Name and Age
Your answer
Child #3: Name and Age
Your answer
Medical Concerns, Allergies, or Dietary Restrictions?
Your answer
Photo Release *
Required
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