Registration
Parents’ Night Out (PNO) is for children ages 4 – 12 years old and held on Saturday nights. Our incredible staff will provide an evening full of games and activities, as well as providing dinner, snacks and water for all students for only $25.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Please list any allergies:
New! You will drop off & pick up your child at the back door of the gym. Please drive behind Sun Medical and turn left down the alley. We will get your child out of the car for you. (checked=yes)
Do you have a coupon? Please put in coupon code & bring with you to the event
 
Additional Information:
 
Waiver
  (Show-Hide Details)
I've read the above and agree.
 
Photo Release
  (Show-Hide Details)
I've read the above and agree.
 
No refunds
  (Show-Hide Details)
I've read the above and agree.
 
New Drop off & Pick Up Procedures
  (Show-Hide Details)
I've read the above and agree.
 
Enter your Full Name: *   
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*