Parents Night Out 4/26/24
We look forward to seeing your child(ren) at Parents Night Out (PNO) and for you to get a much deserved night off!

Here is the information for the night: 
Date: 4/26/24
Age: 2 years old - 5th grade 
                    Limited spots for kids age 2-4
Time: 6:00 - 9:00 pm *please feel free to drop off late and/or pick-up early as needed. If you are planning this in advance please put that in the notes section of this form. 
Location: Central Baptist Church 
                 28 E Highland Ave, Atlantic Highlands, NJ 07716
                 *Please use the driveway 'office' entrance for both drop-off and pick-up. 
Questions/Concerns: Email Rebecca DeLucia - kids@cbcah.org 

Registration closes 04/24/24

Throughout PNO we offer crafts, games, snacks and activities. Please note that we do not offer dinner. 

FYI: If you have older children we have a Youth Group for 6th - 12th grade that meets on Wednesdays from 7:00 - 8:30pm. Email rebecca@cbcah.org for more information or if they would like to volunteer during PNO. 
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Email *
First Child's Name, Date of Birth, and Grade-level *
Second Child's Name, Date of Birth, and Grade-level
Third Child's Name, Date of Birth, and Grade-level
Fourth Child's Name, Date of Birth, and Grade-level
If more than four of your children will be attending please list them in the section "other concerns / notes." Thank you. 
Primary Contact Name (First and Last) and Phone Number *
Secondary Contact Name (First and Last) and Phone Number *
Emergency Contact Name (First and Last) and Phone Number (different than above) *
Allergies or Medical Conditions  *
Any other concerns or notes
In the event that a Medical Emergency occurs, I authorize Central Baptist Church to seek medical help for my child as deemed necessary by the teacher or adult present.  *
Parent Electronic Signature  *
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