Kids Chill Down Water Event & Parent Night Out
FRIDAY, August 19, 2022 / 6p-10p / held at New Hope Christian Church / 9850 S. FM 1660, Hutto TX 78634
Sign in to Google to save your progress. Learn more
Email *
Join us for a great night.  Parents, drop the kids off starting at 5:45pm, and go enjoy a date night.  Ages 3 years - 5th Grade.  Bring towel, appropriate swimsuit, night clothes/change of clothes, blanket, stuffed animal, etc.  We'll have a giant water slide, water balloons, ice games, ton of "cool" fun & games outside.  Then, we'll have dinner, crafts, and wind down our "Chill Down, 'Winter in Summer'" Event watching a (Christmas) Movie.  Free!  Please pick up by 10pm.
An Email Confirmation will be sent following your submission as proof of your registration.
Child's Full Name (additional children can be added below) *
Address *
Grade Level / Age *
Data of Birth *
MM
/
DD
/
YYYY
Please list any medical issues, health issues, medicines taken, growth issues, developmental issues, etc. that we need to know that may impact your child while with us.  Also, this will help us in making sure your child has a great time at the event with us.
List Name of Person dropping off child(ren) *
List Name of Person(s) who may pick up my child(ren) after event *
Estimated Drop off time (from 5:45p onward) *
Name(s) and Phone Number(s) of Parents/Guardians *
Name/Relation and Phone Number of 2nd Emergency Contact *
*I understand that the Sponsors of the event will make every attempt to contact me and the 2nd emergency contact with any medical issue, but should I not be able to be reached, I understand that immediate medical care may be needed, and I authorize the Sponsors to seek and provide medical attention including, but not limited to dental, emergency, hospital, ambulance, doctor, etc. if needed during the event.  By typing my full name and "Yes" below, I agree to this. *
*I have asked any questions regarding the event’s activities, and I allow my child(ren) to participate in the related activities and programs.  I understand any and all risks that may occur by participating, and I release and agree to not hold blameless the church or sponsors for illness or injuries.  Also, If my child(ren) does not follow the rules, I agree to come and pick up my child(ren).  Please type full name and word "yes" to agree. *
I have read and agreed that this form has been filled out completely by me, and agree to such by typing my full name and "Yes" in the line below.  Please also add the month of the signee's date of birth for confirmation. *
Additional Children Attending
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms