Registration
It's Parents' Night Out - Back to School edition! You've been working hard getting your child set for school... meeting teachers, making lunches, getting the exact notebook that your child needs from that specialty store in Short Hills. Now, you deserve some time for you. Get 5 whole hours to yourself at Parents' Night Out on Saturday, September 28th from 5PM-10PM! Yes, 5 whole hours to do whatever YOU wish! While your children are having a grand ol' time, you could see a movie, go to dinner, or even sit and do nothing. Whatever your heart desires.??
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 (Not Contact #1 or #2)
 
 
Students entered below will be added to your family's account
 
Additional Information:
 
Waiver
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I've read the above and agree.
 
Photo release
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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:*