Parents Night Out

Need a night to shop, wrap gifts, or just enjoy peace and quiet? Drop your kids off with our responsible 8th-grade students (and their parents)! We'll provide a fun, safe, and engaging night for your children while you enjoy a much-needed break.

Who: Children ages 3-12 Must be potty-trained
What: Games, movies, and supervised fun!
When: Sunday, December 7th 3:00 pm- 6:00 pm
Where: St Peter Gym – Bartz Hall Entrance
Why: All proceeds go directly to funding the 8th Grade Washington D.C. Trip, helping our students experience history firsthand!
Cost: Suggested minimum offering of $45 per child

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Parent's Name Parent's Name First Last
Parent's email
Parent's Phone Parent's Phone - ### - ### ####
Other contact in case of emergency: Other contact in case of emergency: First Last
Other contact phone number in case of emergency: Other contact phone number in case of emergency: - ### - ### ####
Approx. time of drop off Approx. time of drop off : HH MM AM/PM
Approx. time of pick up Approx. time of pick up : HH MM AM/PM
Student's name Student's name First Last
Student's age
Suggested minimum offering of $45 per child $ Dollars . Cents
HOLD HARMLESS AGREEMENT (INDIVIDUAL’S)
I agree on behalf of myself and my minor children (if any) to release, defend, indemnify, and
hold harmless the St. Peter Lutheran Church and School, its elected and appointed officials,
employees and volunteers and others working on behalf of St. Peter Lutheran Church and School against any and all claims, demands, suits, loss, including all costs connected therewith, for any damages which may be asserted, claimed or recovered against or from St. Peter Lutheran Church and School, its elected and appointed officials, employees, volunteers and others working on behalf of St. Peter Lutheran Church and School, by reason of personal injury,
including bodily injury and death, and /or property damage, including loss of use thereof, which arises out of or is in any way connected or associated with my use of, or presence on, St.
Peter Lutheran Church and School land and facilities) pursuant to St. Peter Lutheran Church and School permission therefore, which is hereby granted.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Family Physician Phone Family Physician Phone - ### - ### ####
EMERGENCY TREATMENT PARENT CONSENT FORM
TO WHOM IT MAY CONCERN: As a parent or guardian, I do herewith authorize the treatment by a qualified and licensed medical doctor of the following minor in the event of a medical emergency which, in the opinion of the attending physician, may endanger his or her life, cause disfigurement, physical impairment or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me. This also includes permission to transport said individual to a hospital and if necessary, back to home or our school.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Specific medical allergies, chronic illnesses or other conditions:
Would you like to register a another child?

Would you like to register a another child? Yes No
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Parents Night Out

Parents Night Out

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Parents Night Out