Thank you for participating in Parent's Night Out at Northeast! Please remember that parents MUST drop off and pick up their children. Cost for the evening is $5/kid or $10/family. Dinner will be provided for the children as well as fun activities.

Child's Name *
Child's Name
Child's Birthdate *
Child's Birthdate
Parent/Guardian Information
Parent/Guardian Name *
Parent/Guardian Name
Phone Number *
Phone Number
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