First Presbyterian Church in Weslaco

FIRST PRESBYTERIAN CHURCH
WESLACO, TEXAS
PARENTS' NIGHT OUT RESERVATION
EVENT DATE *
PARENT: *
CHILD: *
CHILD:
CHILD:
CHILD:
PHONE: *
AGE: *
AGE:
AGE:
AGE:
$10.00 per family (cash is appreciated)
Do any of your children have
ALLERGIES TO ANYTHING? If so, please list child and allergy
MEDICAL OR OTHER CONDITIONS of which we should be aware?
SPECIAL NEEDS:
CHILD'S DOCTOR:
DR.'S PHONE:
In the event of an emergency, I hereby approve any First Presbyterian Church staff member or leader to seek appropriate medical attention for my child. I do not hold First Presbyterian Church, Weslaco, Texas, or any staff member or leader financially responsible.
Parent's Name:
Date:
Phone # where you may be reached during PNO!
Parents will sign the form when kids get dropped off.

PARENTS' NIGHT OUT RESERVATION