PARENTS’ NIGHT OUT

SUNDAY, FEBRUARY 16

5 PM-9 PM

Fun & safe care for keiki, ages 2-12

This Parents’ Night Out is a fundraiser for the Alaska Mission Trip. We recommend a donation of $20/family/hr.

KEIKI REGISTRATION

Parent/Guardian Name

First Name

Last Name

Phone

(###)

###

####

Name(s) & age(s) of Keiki who will be attending Parents' Night Out

Please detail any allergies or care instructions for your keiki

By registering my child(ren), I give my consent for University Avenue Baptist Church to use my child's photographs and video footage in church promotion, publicity, and website.

I Do

I Do Not

SPONSOR A FAMILY

Your Name

First Name

Last Name

If you would like to sponsor a specific family, please type their name below:

I plan to donate:

$20

$40

$60

$80