April 14, 2017 Parent's Night Out Registration
Parent's Night Out is partnering with Learning Fun 101 who will provide 2 Lego Master Builders full of creative ideas and lots of legos for kids to use! Duplos will be available for our younger kids. There will still be plenty of time for free play too and 2 of our regular Servant Church childcare workers to support all the kids.

Please complete this form to register for Parents Night Out. **Children between the ages of 2-10**
* RSVP and payment must be received by Wed May 9. $25 for first child, $10 all other children
* Please pay online - use the Parents Night Out designation: servantchurchaustin.org
* Childcare will be at Servant Church in the Fellowship Hall
* Drop off will start at 5:30 pm.
* Pick up will be anytime before 9:00 pm.
* Dinner will be provided for children during this time.

Email address *
Parent's First Name *
Your answer
Parent's Last Name *
Your answer
Parent's Cell Phone *
In case we need to reach you.
Your answer
Child's Name *
Your answer
Child's Age *
Reminder - child must be a "walker". We do not have the ability to care for infants.
Your answer
Please list any food allergies your child has: *
Your answer
Important things we should know while watching your child: *
Please include information about potty training/diaper changes, etc.
Your answer
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