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Parent's Night Out Registration

Ages 3-10

Parents can take an evening off while their children partipate in fun activities like learning about Jesus, crafts, songs, games, and more! Children do need to be potty trained. Space limited to 40 children, and registration is on a first-come first-serve basis.

Parent Information

First Name

Last Name

Address

City

State

Zip

Phone #

E-Mail

Child Information

Name

Date of Birth

Any Medical Condition or Allergies (including food allergies)

Child Information

Name

Date of Birth

Any Medical Condition or Allergies (including food allergies)

Additional Information

Do you have a church home?

Yes
No

If yes, what is the name of the church?

How did you hear about us?

Verify

Parent's Night Out is a free service provided by Abiding Word Lutheran Church.

Contact information will never be used for sales, telemarketing or any other unauthorized or inappropriate use.

Parent's Night Out Registration

Ages 3-10

Parent Information

Child Information

Child Information

Additional Information

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