Parents' Night Out Registration

Bring your kids for a fun night of pizza and activities!
Saturday, March 7 · 4:30–7:30 pm · Free Church (3000 E. Main)

Enjoy a kid-free evening while loving and supporting a family, a child, and the significant costs of private adoption! This fundraiser is sponsored by our local Foster the Family chapter, and all proceeds go toward adoption expenses for Aaron and Lydia Leggett. Suggested donation of $20/child.

Interested in helping out? Click here to fill out a volunteer form.

Want to donate to the Leggett Family's adoption fundraiser? Click here to give online.

Parent/Guardian Information

Name*

First NameLast Name

Cell Number*

E-mail*

Child Information

Child's Name*

First NameLast Name

Age*

Do you have additional children to register?

yes

Child's Name

First NameLast Name

Age

Child's Name

First NameLast Name

Age

Child's Name

First NameLast Name

Age

Child's Name

First NameLast Name

Age

Child's Name

First NameLast Name

Age

Child's Name

First NameLast Name

Age

Child's Name

First NameLast Name

Age

Do your children have any dietary restrictions, allergies or medical conditions we should be aware of? If so, please describe.

Emergency Contact and Participation Agreement

Additional Emergency Contact

First NameLast Name

Phone Number

By checking this box and submitting this form, I acknowledge that this constitutes my electronic signature and agreement to the following for all participants listed on this form.

Event: Parents’ Night Out — Adoption Fundraiser for the Leggett Family
Date & Time: Saturday, March 7 | 4:30–7:30 PM
Location: Evangelical Free Church, 3000 East Main St., Cañon City, CO 81212
Sponsor: Foster the Family
Contact: Larissa Blackwell

I am the parent or legal guardian of the participant(s) listed above and have the authority to sign this agreement.

I understand that my child(ren) will be participating in supervised activities and may be active and interacting with other children. I accept responsibility for any injury or medical care needed during the event and confirm that I have provided any relevant medical or emergency contact information.

I release and hold harmless Foster the Family, Evangelical Free Church, and their representatives from any claims or actions arising from participation in this event, including those resulting from negligence.

I understand that my child(ren) is expected to follow the instructions of event staff and volunteers.

We look forward to a fun and safe evening for the children while parents enjoy a few kid-free hours!

Participation Agreement*

I have read and agree to the Participation Agreement for all participants listed above.

Today's Date*

Date