2021-2022 Parent Night Out Registration Form
Please complete one form per family. The cost will be $10 per family and you can pay the night of the event using cash, card, or check. Registration will close 1 week prior to the event. There is a 5 child minimum to host the event.
Sign in to Google to save your progress. Learn more
Email *
Date (You may sign up for all that you would like to attend) *
Required
Child #1 *
Child #2
Child #3
Child #4
Parent/Guardian Name *
Parent/Guardian Phone Number *
Parent/Guardian Email *
Emergency Contact Name and Phone Number *
Please list any allergies, special concerns, etc. that you would want the staff and volunteers to know about your child. *
I am aware of the risks inherent to participation and active physical exertion in the above-named program. I am aware that there are always certain risks involved and I declare my child, physically sound and have medical approval to participate in the above-named sport, exercise or program.We hereby waive, release, absolve, indemnify, and agree to hold harmless the PRYC, the organizers, all officers, directors, sponsors, supervisors, participants, volunteers, employees, agents and instructors any claim arising out of an injury, disease, illness or accident. I hereby do not declare any physical problems or restrictions and declare the participant to be in good physical and mental health. I have read, understood, and agreed to all of the above information here in his form. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy