Parents' Night Out 2023

Parent/Guardian Information

Name

This address will receive a confirmation email

Primary Phone

Secondary Phone

Who will be picking up the children?

Child Information

Child 1 Name

Child 1 age/birthday

Child 1 School

Please describe any allergies, special needs, and any other relevant information so we can best care for your child:

Child 2 Name

Child 2 age/birthday

Child 2 School

Please describe any allergies, special needs, and any other relevant information so we can best care for your child:

Child 3 Name

Child 3 Age/Birthday

Child 3 School

Please describe any allergies, special needs, and any other relevant information so we can best care for your child:

Child 4 Name

Child 4 Age/Birthday

Child 4 School

Please describe any allergies, special needs, and any other relevant information so we can best care for your child:

If there is anything the adults need to know about your children that can help us support them during this time.

Would you like to donate for child care? (You don't have to, we're offering this opportunity for free) If you would like to donate, enter an amount, otherwise leave blank.

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Feb 11 5-8 PM

Parents' night out is an opportunity for our families to have a night out during the month of Feb. Parents' night out will be Feb 11 5-8 PM. We will have light snacks, arts & crafts and games for our young children. Parents' night out is for children 10 and under. YOU HAVE TO REGISTER TO ATTEND.

Parents' Night Out 2023

Description

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