Shopping Night- Parent's Night Out- Friday December 7th 6:00-9:00PM
Drop off your kids any time between 6:00 and 9:00.

Ages: Potty trained 3 year olds to 11 years old!
December 7, 2018 from 6:00 to 9:00PM

We'll serve them dinner (6:15-6:45) & snacks*, play games, do crafts, and watch a movie! *If you plan to arrive after 6:45 they will not receive dinner, so please make sure to feed them before they come.

ALLERGIES:
We plan to serve a dinner of hot dogs, macaroni and cheese, and some fruits and veggies. *If your child has allergies that would prevent them from eating what we will be serving, please bring them dinner. Mark their food clearly with their first and last name. Thank you!

Email address *
Parents Name (first, last) *
Your answer
Phone Number *Please list a number we can contact quickly, if needed. *
Your answer
Street Address *
Your answer
City *
Your answer
State (Example: WA) *
Your answer
Zip *
Your answer
Name of 1st Child and Age (name,age) Example: William,4 *
Your answer
Name of 2nd Child and Age (name,age)
Your answer
Name of 3rd Child and Age (name,age)
Your answer
Name of 4th Child and Age (name,age)
Your answer
Name of 5th Child and Age (name,age)
Your answer
Name of 6th Child and Age (name,age)
Your answer
Are there any allergies or other medical conditions we should be aware of? Please list the child's name and the condition. Example: William,peanut allergy *
Dinner will be provided from 6:15-6:45. Will your child need dinner? (Please make sure to feed your child if they are arriving after 6:45) *
Home Church: *
I would like more information about: *
Required
Questions?
If you have any other questions about the event please feel free to call: Chad Gothmann (509) 953-5824
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