Parents' Night Out Sign Up
Taylor Academy of Dance
Student Contact Information
Student's Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student's Age
*
Current Age
Student Phone Number - if Applicable
-
Area Code
Phone Number
Student's Email
Confirmation Email
Medical Issues/Allergies/Areas of Concern
*
Please list any physical issues or areas of concern that may affect your child.
Parent Contact Information
Parent's Email
*
Confirmation Email
Parent
*
Emergency Contact
*
Who is picking your child up?
*
I will be picking my child up
Someone else will be picking my child up (Note: If you select this option you will be required to fill out the information below!)
Authorized Pick Up Name
Relationship to Child
Phone Number or Email
Click On Option to Select
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Parents' Night Out - One Child
$40.00
$
40.00
Admission for one child to attend Parents’ Night Out. Includes dance activities, games, crafts, movie time, snacks, and supervised summer fun from 6:00 PM – 9:00 PM.
Parents' Night Out - ONE Additional Child/Friend
$25.00
$
25.00
Discounted admission for each additional sibling attending Parents’ Night Out. Includes all event activities, snacks, and supervision.
Parents' Night Out - TWO Additional Children/Friends
$50.00
$
50.00
Add two additional siblings to the event. Each child will receive full admission to all activities, movie time, snacks, and supervision.
Parents' Night Out - THREE Additional Children/Friends
$75.00
$
75.00
Add three additional siblings to the event. Each child will receive admission to all activities, movie time, snacks, and supervision.
Late Pickup Option - ONE HOUR (10PM Pickup)
$20.00
$
20.00
Need additional flexibility? Purchase an extra hour of supervision.
Late Pickup Option - TWO HOURS (11PM Pickup)
$40.00
$
40.00
Need additional flexibility? Purchase an extra two hours of supervision.
Late Pickup Option - THREE HOURS (12AM Pickup)
$60.00
$
60.00
Need addition flexibility? Purchase an extra three hours of supervision.
Total
$0.00
$
0.00
Credit Card
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