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Parents Night Out Registration

Drop your kids off at Grace Point Church and enjoy a night out. Your kids will enjoy pizza, a movie, and games. Register your child today – it’s free!

"*" indicates required fields

Parent/ Guardian's Information

Your Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How Many Children Are You Pre-Registering?*

Please enter a number from 1 to 5.

If you have more than 5 children, please fill out this form a second time with the remaining children’s names.

Your Child's Information

Name of 1st Child*

First Last

1st Child's Birth Date*

MM slash DD slash YYYY

Do your 1st child have allergies?*

Yes

1st Child's Allergies*

Please list out your child’s allergies

Name of 2nd Child*

First Last

2nd Child's Birth Date*

MM slash DD slash YYYY

Do your 2nd child have allergies?*

Yes

2nd Child's Allergies*

Please list out your child’s allergies

Name of 3rd Child*

First Last

3rd Child's Birth Date*

MM slash DD slash YYYY

Do your 3rd child have allergies?*

Yes

3rd Child's Allergies*

Please list out your child’s allergies

Name of 4th Child*

First Last

4th Child's Birth Date*

MM slash DD slash YYYY

Do your 4th child have allergies?*

Yes

4th Child's Allergies*

Please list out your child’s allergies

Name of 5th Child*

First Last

5th Child's Birth Date*

MM slash DD slash YYYY

Do your 5th child have allergies?*

Yes

5th Child's Allergies*

Please list out your child’s allergies

Comments

This field is for validation purposes and should be left unchanged.

At Grace Point Church in Surprise, AZ, we're on a mission to see lives changed by Jesus.

Join Us This Sunday!

Join us for our 9:00 AM or 10:30 AM service
16761 N West-Point Pkwy, Surprise, AZ 85374

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