Tyler Street Kids Parent's Night Out Enrollment Form
2/16/2018
Join us for Parents Night Out, Kids Night In.
From 5:00pm-9:00pm
Sign up today space is limited! Once we full we will start a wait list.
Ages 6 weeks-5th Grade
$10 for single kid| $18 for Two | $25 for Three| $8.00 per kid Four or more.
Parent's First Name *
Your answer
Parents Last Name *
Your answer
Address *
Home address of Parents
Your answer
Parent's Phone Number *
Your answer
Email Address
Your answer
Child 1 Name *
First and Last name
Your answer
Child 1 age *
How old is your child?
Your answer
Child 2 Name
First and Last Name
Your answer
Child 2 age
How old is your child?
Your answer
Child 3 Name
First and Last Name
Your answer
Child 3 age
How old is your child?
Your answer
Child 4 Name
First and Last Name
Your answer
Child 4 age
How old is your child?
Your answer
Allergies (food etc.), Medical alerts, special requests, etc.? (For food allergies/dietary restrictions, please send food with your child that they can eat) *
Your answer
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