Parents Night Out

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Child's Name*

Child's Age*

Parent's Name*

Parent's Email*

Parent's Phone*

Emergency Contact*

Emergency Contact Phone*

Relationship to Child*

Child's Allergies

Parent's night out slot*

Friday, November 15, 2019 (6-8pm)

Friday, November 22, 2019 (6-8pm)

Tuesday, November 26, 2019 (6-8pm)

Friday, December 6, 2019 (6-8pm)

Friday, December 13, 2019 (6-8pm)

Friday, December 20, 2019 (6-8pm)

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* For an extra $15 (per child), your child may stay until 9:00pm instead of 8:00 pm.

* Please note that payment is due at the beginning of the parent’s night out session.