Parent's Night Out Registration Form

Parent's Night Out Registration Form

Register your child for a few hours of supervised playtime with supper included while you enjoy your Christmas shopping. ***Preschool entrance is located at the back of the building.***
Parent's Full Name

First NameLast Name
Parent's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent's Email Address
example@example.com
Child's Full Name

First NameLast Name
Child's Age
Child's Birthday

MonthDayYear
Date
Does your child have any allergies or dietary restrictions? Please specify.
Does your child have any medical conditions that we should be aware of?
Permission to administer first aid if required
Emergency Contact Name
Will your child need one-on-once care or any other inclusion supports? (Please explain.)
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please list the people who are authorized to pick up your child
Additional information or special instructions
Are you registering any siblings? In addition to filling out a separate registration form, please list their names here.
How will you pay?
Event Details: This is a one-time drop off event with supervised activities and supper included. The event will take place on Saturday December 13th from 4:00 PM to 7:00 PM. By registering, you agree to the supervision and safety guidelines provided by BCBC Preschool.

Registration will be capped at 30 children, on a first-come first-served basis.

**BCBC Preschool (Meghan) will reach out to you by e-mail to confirm registration and payment information.**
Please e-mail bcbcpreschoolhalifax@gmail.com if you have any questions
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