Parent Night Out (8/21)- Participant Registration

Parents' Night Out is an opportunity for our youth to serve our church family with childcare. We are planning a fun-filled night for your kiddos with VBS-inspired stations: organized games, storytime, PIZZA, and a movie to close it all out. Any child from age 3 through rising 5th grade is welcome to participate!

Drop off will be at 5:30pm. Pick up from 8:00-8:30pm. And if you need to pick up sooner, just let us know in the form below or contact Emily Beilman.

This event is for Redeemer members/regular attendees only. Registration for this event will close at 11:59PM Friday, August 14th!

Please reach out to Emily Beilman (919) 820 4284, with any questions or concerns about this event.

Parent Information

Please fill out the following information so that Parent Night Out Volunteers can reach you!

Parent Name

This address will receive a confirmation email

Phone

Address

Suggested Donation

Child Information

Child 1 - Name

Child 1 - Age/Grade

Does your child have any food allergies or medical needs?

Yes No

If you responded "Yes", please describe your child's food allergy or medical needs here.

Child 2 - Name

Child 2 - Age/Grade

Does your child have any food allergies or medical needs? Yes No

If you responded "Yes", please describe your child's food allergy or medical needs here.

Child 3 - Name

Child 3 - Age/Grade

Does your child have any food allergies or medical needs? Yes No

If you responded "Yes", please describe your child's food allergy or medical needs here.

Emergency Contact

Emergency contact name

Phone

Additional questions/comments/concerns

If there is anything else you'd like to share about your child, early pick-up needs, etc, use the space below to do so!

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Parent Night Out (8/21)- Participant Registration

Description

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