Parent's Night Out Enrollment Form
8/18/17 Parents Night Out from 5:00pm-9:00pm! Space is limited: first come, first served and when we're full you'll be on the waitlst (for children 6 weeks-5th Grade only), $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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