eSPACE

Prince of Peace Lutheran Events

Event: Parents' Night Out

Date: Saturday, Aug 10, 2024

Time: 5:00 PM — 8:00 PM

Ticket(s):	One Child - $15.00
	Family Price - $30.00

Childcare offered 5:00 to 8:00 pm, $15 per child/$30 per family. POP Childcare Staff are First-Aid/CPR certified and have background checks.

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Ticket Type

One Child - $15.00

Family Price - $30.00

Personal Information

First Name *

Last Name *

Email *

Address *

City *

State *

Zip *

Cell Phone *

Child's Name (1) *

Child's Age (1) *

Please list food allergies, dietary or health concerns. (1)

Please include notes regarding potty training, special items in diaper bag, etc. (1)

Child's Name (2)

Child's Age (2)

Please list food allergies, dietary or health concerns. (2)

Please include notes regarding potty training, special items in diaper bag, etc. (2)

Child's Name (3)

Child's Age (3)

Please list food allergies, dietary or health concerns. (3)

Please include notes regarding potty training, special items in diaper bag, etc. (3)

Child's Name (4)

Child's Age (4)

Please list food allergies, dietary or health concerns. (4)

Please include notes regarding potty training, special items in diaper bag, etc. (4)

Permission to use child(ren)'s photo (no names) in promotional materials, print and social media.

Yes

I want to be reminded