Parents Night Out

June 23, 2023

5:30pm-9:30pm
Enjoy a night for yourselves once a month and let us watch your children aged 0-10. We offer playground time (weather permitting), crafts, games, pizza, and a movie with popcorn. PNO is supervised by MinistrySafe trained and background checked staff.

The cost is $25 for the first child, $15 for each additional child per household. Children must live under the same roof for this discount.

We cannot accept walk-ins. If you are unsure of your registration status or have questions, please reach out to kristina@foundationgmc.org.

Due to the purchasing of supplies, full refunds can't be processed with less than 24 hours notice. Attendance is limited, so don't delay--register online today!

Foundation Church

10751 W Adams

Temple, TX 76502

foundationgmc.org
Your Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mobile Number*
E-mail*
example@example.com
Accident Release, First Aid, and Financial Responsibility Wavier

Please read and sign below. Registration forms cannot be accepted without a signature.

By signing, I declare that I understand the inherent dangers involved with my child’s participation, including the risk of personal injury and/or damage to my child and/or my property while participating. I authorize and grant permission for a representative of Foundation Church to treat minor injuries including scrapes, small cuts, splinters, and insect bites. I authorize and grant permission for a representative of Foundation Church to obtain emergency medical care from any licensed physician or hospital and/or medical clinic should my child become ill or injured while participating in activities away from home or at other times when neither parent nor guardian is available to grant authorization for emergency treatment. I therefore freely and voluntarily execute this release with such knowledge, assume the risk of personal injury and/or property loss arising from or in any way connected with participation in this program offered by Foundation Church. I hereby release and discharge Foundation Church and any and all agents of Foundation Church from any liability, claim, cause of action, demand or damages from injury or damages of any kind to my child or my property as a result of participation in Parents' Night Out. I have read the Parents Night Out rules (listed below) and understand that my child and I must adhere to them. I understand that should my child become a disruptive force during Parents' Night Out that the instructor may choose to release him/her from the program with no refund. Aggression towards staff or other children will not be tolerated.

Parents Night Out Rules and Regulations

1. Everyone must follow the instructions of PNO staff.

2. All participants must take part in all scheduled activities.

3. No electronics are allowed. These items should be left at home.

4. No running or horseplay is allowed indoors.

5. Please leave valuables at home (rings, jewelry, etc.). Foundation Church will not be responsible for lost, damaged, or stolen items.

6. All participants are expected to treat others with kindness and respect.
Signature*

Clear
Child #1*

First NameLast Name
Child #1 DOB*

MonthDayYear
Date
Allergies/Medical*
Child #2

First NameLast Name
Child #2 DOB

MonthDayYear
Date
Allergies/Medical
Child #3

First NameLast Name
Child #3 DOB

MonthDayYear
Date
Allergies/Medical
Child #4

First NameLast Name
Child #4 DOB

MonthDayYear
Date
Allergies/Medical
Child #5

First NameLast Name
Child #5 DOB

MonthDayYear
Date
Allergies/Medical
Child #6

First NameLast Name
Child #6 DOB

MonthDayYear
Date
Allergies/Medical
Payment*
prevnext( X )
Number of children attendingChildren must be from the same household.
$25.00 Quantity

Total

$0.00
Should be Empty:

June 23, 2023