Rejoice! Parents' Night Out Registration Form
This event will take place on Friday, December 13, 2019, 6PM-10:00PM. Please complete the form below to register your child or children.
Email address *
First child name and age *
Your answer
Second child name and age
Your answer
Third child name and age
Your answer
Additional child(ren) names and ages
Your answer
Parent/guardian Name(s) *
Your answer
Street address *
Your answer
City, state, zip *
Your answer
Home phone
Your answer
Cell phone
Your answer
Emergency contact name *
Your answer
Emergency contact phone number *
Your answer
Would you like to receive our newsletter via email to be informed of other Rejoice! activities that you or your children may wish to participate?
Food Allergies or Medical Conditions that we should be aware of: *
Your answer
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