Parents Night Out Registration Form

Parent's Night Out: November 26th

Price per child: $35

10% discount for the second child and up!
Parent Contact Information:
Parent Name

First Name Last Name
E-mail
example@example.com
Phone Number:
Child(s) Details:
Number of kids*
Child Name*

First Name Last Name
Dietary Requirements*
Separate multiple requirements with commas
Child Name 2

First Name Last Name
Dietary Requirements
Separate multiple requirements with commas
Child Name 3

First Name Last Name
Dietary Requirements
Separate multiple requirements with commas
Child Name 4

First Name Last Name
Dietary Requirements
Separate multiple requirements with commas
Payment option*

Online (on this form)I have a voucher
Total Estimate
Amount due in person
Payment

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Payment Method at gym

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