Parents Night Out

The Gilford Youth Center is offering a Parents Night Out. A chance for Parents/Caretakers to go out for a special night with a kid free evening! Enjoy a date night or just a quiet night in.

We welcome potty-trained children ages 2-12 to join the GYC staff for a night of fun at the Gilford Youth Center.

Activities will include:

games/ free play
jumpy slide
movie
pizza dinner, water
craft

Date: Friday, October 15th

Times: 5:30-8:00

Cost: $25 & $15 for each additional sibling

Space is limited to 20, payment is required to reserve your spot.

Parents Night Out Registration

* Indicates required field

Parents Name *

First

Last

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Has your child attended PNO before? *

Yes No

Childs Name #1 *

First

Last

Childs Age #1 *

Childs Name #2 *

First

Last

Childs Age #2 *

Childs Name #3 *

First

Last

Childs Age #3 *

Emergency Contact *

First

Last

Emergency Contact Phone Number *

Please indicated any allergies or medical conditions we should know about *

Participation in this program may involve risk of injury. As a parent, guardian or participant, I am aware of these hazards and my child’s ability to participate. In consideration for participation in the program listed above, I hereby for myself, my heirs, executors and administrators waive and release all rights against the Gilford Youth Center, the Gilford Community Church, its officers, employees, agents, volunteers, and supervisors, except in the case of their sole negligence, from all losses, injury, damages, fees, and other expenses, arising out of or in connection with participation in the program and activities. In addition, I give my permission for the child to be treated by qualified medical personnel in the event that the above named parent/guardian cannot be reached at the phone numbers provided. As a parent, guardian or participant, I allow the Gilford Youth Center to take my child’s picture/video for advertising and promotional purposes. *

I agree to the terms stated above

Name *

First

Last

Submit