Parents' Night Out Child Registration

Thank you for providing information about your child for Parents Night Out. Please submit a different form for each child.

If you have already filled this out for the 2025-2026 church year, you do not need to fill it out again for future Parents' Night Out events.

Thank you!

Parental/Caregiver Information

Parent Name

This address will receive a confirmation email

Phone

Address

Spouse's Name

Spouse's Email

Spouse's Phone

Spouse's Address

Emergency Contact Name

Emergency Contact Phone

Child Information

Child Name

Age

Birthdate

Grade

Allergies and other medical concerns

Anything else we should know about your child?

Description

Third Sunday of the month

Please fill out this form and click submit.

Parents' Night Out Child Registration

Description

Please Fix the Following