Parents' Night Out

from 6:30 to 9:30 p.m.
• The program is for children aged 10 and younger.

Friday, April 5, 2013 Now full. Waiting list available.

Parents' Night Out with child care at the church.
Registration Deadline is Friday 10:00 a.m. the day of the event. However, space is limited, so please register early because once spaces are full, sign-ups will be closed.

Parents' Night Out includes age-appropriate activities for all ages (10 and younger).

• In addition to the adult supervision, a Security Guard will also be on duty at the church.
• Cost: $7.00 per child.
• SIGN-UP ONLINE BELOW: Complete the form below and submit it (The form will be emailed automatically to Jeannine Usher at the church.). You can put your payment in the PNO Sign-Up Box or bring your payment and pay that night.

Fill out a separate form for each child.

• OR PRINT THE FORM AND TAKE IT TO THE CHURCH:

print out a form, complete it (one form per child) and drop it with your check in the Sign-Up Box.
The Parents' Night Out Sign-Up Box is located in the hallway near the elevator and receptionist's desk.
• Cancellations: Cancellations must be made no later than 24 hours in advance. Cancellations received by Noon on the Wednesday preceding the event will receive a credit towards the next Parents' Night Out. No refunds.
• When we have reached our capacity of 40 children, we will begin a waiting list.

• For children not interested in the posted movies, you may provide a book, personal hand-held video game, or craft.
Questions? Contact Jeannine Usher or 205.933.3694

SIGN-UP ONLINE

Parents' Night Out (PNO) Sign-Up Form

Below: Fill out ONE FORM PER CHILD

Cost: $7.00 per child/per night. If you sign up on-line, you can put your check in the PNO Sign-up Box or bring your payment that night.

Check the box below for date you're signing up:

Friday, April 5, 2013 6:30-9:30 p.m. April 5 PNO is now full. Please sign up for the waiting list. Usually every month we have openings during the week, and we'll let you know if there's a spot for your child. Thanks!

REMINDER: PNO ends promptly at 9:30 p.m. There will be a $5.00 late fee (per child) for every 5 minutes after 9:30. Thanks for understanding that our nursery staff needs to leave on time.

Fill out a separate form for each child.

Child's Name:

Child's Age:

Parent(s) Name:

Parent(s) Cell Phone Number(s):

Emergency Contact Phone Number and Relationship:

(Someone other than child's parents)

Special instructions for child (ex. bottle time; allergies, etc.)

You must press "Submit Form" to send the information on each child to Jeannine Usher.

You will then be redirected back to this page. For multiple children, repeat the process. Thanks!

Remember: One form per child