2026- St. Andrew’s Summer Adventure Nights

St. Andrew’s Summer Adventure Nights Registration

For Children Nursery through 4th grade
Child's Name

First NameLast Name
Birth Date

MonthDayYear
Grade Fall of 2026
Please select which dates your child will be attending the parent's night out.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name

First NameLast Name
Parent/Guardian Mobile Number
Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Parent/Guardian Name

First NameLast Name
Parent/Guardian Mobile Number
Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Emergency Contact Name

First NameLast Name
Emergency Contact Mobile Number
Format: (000) 000-0000.
Emergency Contact Email
example@example.com
Authorized Pick-up People - Name and cell number
Allergies, medical needs, medications, dietary restrictions
Photo release - Allow photos of your child in church publications, online and social media
Additional Comments
Should be Empty:

St. Andrew’s Summer Adventure Nights Registration