KUMC Parents Night Out Registration
Parents Night Out
Fridays September 22, October 27th, and December 8th
All ages welcome!
$20 for one child, $15 each additional
Enjoy a night off while your kids have fun playing games, doing crafts, and other fun activities! Dinner is provided!
Contact Jessica at jessicah1126@gmail.com or 678-778-6657 with any questions!
Child #1 Name
Your answer
Child #1 Birthdate
Your answer
Child #1 Grade Level
Your answer
Child #1 Allergies or Special Needs?
Your answer
Child #2 Name
Your answer
Child #2 Birthdate
Your answer
Child #2 Grade Level
Your answer
Child #2 Allergies or Special Needs?
Your answer
Child #3 Name
Your answer
Child #3 Birthdate
Your answer
Child #3 Grade Level
Your answer
Child #3 Allergies or Special Needs?
Your answer
Parent Name
Your answer
Parent E-mail Address
Your answer
Parent Phone Number
Your answer
Emergency Contact #1 Name
Your answer
Emergency Contact #1 Phone Number
Your answer
Emergency Contact #2 Name
Your answer
Emergency Contact #2 Phone Number
Your answer
Emergency Medical Consent-Please e-sign and date your acceptance or denial below.
I authorize a representative of Kennesaw United Methodist Church to transport and give consent for any and all emergency medical care for my child while he/she is in the custody of the church.
Your answer
Photo Consent-Please e-sign and date your acceptance or denial below.
My child has my permission to have their picture taken and the unidentified photo may be used in any church printed materials. These may also be used for publicity purposes.
Your answer
Please check each event you would like to register for
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