Parent's Night Out!  Dec. 16, 2022
Event Timing: December 16 2022  Drop off at 6:00. Pick up by 9:15
Event Address: 6001 A Street, Lincoln, NE 68510
Contact us at (972) 948-2211 or JillLein1@gmail.com
Parent's Name(s) *
Email *
Cell phone number *
Emergency Contact name and cell phone number *
Name(s) and age(s) of attending children *
Dietary restrictions and or allergies? *
Is there anything we need to know to best care for your child/children? 
I understand that I will have to pay $10 per child upon arrival. (Maximum of $20.00 per family) *
Required
A copy of your responses will be emailed to the address you provided.
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