Parents' Night Out Registration Form infant - 3 (please fill out one form per child)
***This form is for children who are infants - 3 years old , please use other form for 4+***
***These children will stay in the church nursery for Parents Night Out***

Union Church - Friday, December 13, 2019 6-9PM

Registration/RSVP due by Tuesday, December 10, 2019

The Youth Ministry of Union Church would like to say 'Thank You' for all the church does and provides for us. To show how thankful we are, we are offering a FREE evening of babysitting, . We will have games, crafts, dinner, and a movie! Children up to 5th grade can be dropped off, while parents get some Christmas shopping done or just spend time together during the busy Holiday season.

Children can be dropped off and picked up anytime within the 3 hours (6-9PM).

Infants and toddler will be in the nursery on the top floor of the CE Building. All other children will be in the youth rooms, lower level of the CE Building. Please enter and check in at the "church office" entrance (between the sanctuary and CE building).

Evening Schedule:
6 - 6:45 PM Games
6:45 - 7:15 PM Crafts and cookie decorating
7:15 - 7:30 PM Dinner
7:30 - 9PM Movie: The Grinch (2018)

Food - we will provide cheese pizza, veggies, fruit, and juice boxes for dinner. Cookies, popcorn, and juice boxes or water during the movie.

Email address *
How are you (your family) associated with Union Church? (Please check all that apply) *
Family Name *
Your answer
Child's Name *
Your answer
Child's Age *
Your answer
Parent / Guardian Name(s) *
Your answer
Parent / Guardian Phone Number *
Your answer
Emergency Contact and Relation to Child *
Your answer
Health concerns: *
Your answer
Potty Trained? *
Any other concerns: *
Your answer
A copy of your responses will be emailed to the address you provided.
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