Southwestern Christian Church
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Parents Day Out
SCCKIDS Check-In Form
FRIDAY FEBRUARY 17, 6:00P-10:00P
We're going to have supper together and an evening of activities, games, movies, and lots of fun!
Please fill out the information completely.
Parent First Name
Parent Last Name
How many children will be attending?
Emergency Contact Name and Phone Number:
Special needs we need to be aware of (list each child seperately):
Known Allergies For Each Child (list each child separately)::
Who Is Allowed To Pick-up The Child ( first and last name, relationship to child, and phone number):