Parents' Night Out
Child's Full Name
*
First Name
Last Name
Grade
*
If siblings or friends will be attending with the child listed above, please list their names and grades here.
Parents Full Name
*
First Name
Last Name
Cell Phone Number
*
-
Area Code
Phone Number
Parent Email
*
For dinner...
*
My child can eat pizza with RISING Kids
I will provide and bring dinner for my child
For drop off/pick up...
*
I'll drop them off at 4PM and pick them up at 8PM!
I'll drop them off or pick them up at another time, listed below.
Allergies or Special Instructions (including dinner, early pick up or any other info)
Submit
Should be Empty: