Silver Wings Parents Night Out

Register for Parents Night Out #4 – Saturday, December 14, 2019

Hebron High School Gym (entrance on West side of campus, across from 9th Grade Center)

6-9pm – Doors open at 5:45pm

Ages 4-11 (* Must be potty-trained)

$25 for 1st Child – $10 Each Additional Sibling

** Pizza & water will be provided.

Email for more information: vp_fundraising@hebronsilverwings.org

Child Information
How many children are you registering?*
Child Name*
First Last
Age*
School*
School-Other
Additional Child 2 Name
First Last
Additional Child 2 Age
Additional Child 2 School
Additional Child 2 School-Other
Additional Child Name 3
First Last
Additional Child 3 Age*
Additional Child 3 School
Additional Child 3 School-Other
Additional Child Name 4
First Last
Additional Child 4 Age*
Additional Child 4 School
Additional Child 4 School-Other
Additional Child Name 5
First Last
Additional Child 5 Age*
Additional Child 5 School
Additional Child 5 School-Other
Additional Child Name 6
First Last
Additional Child 6 Age*
Additional Child 6 School
Additional Child 6 School-Other
Parent/Guardian Information
Parent/Guardian Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Home Phone
Mobile Phone*
Emergency Contact Information
Emergency Contact Name*
Emergency Contact Phone*
HHS Silver Wings Release of Liability:
I give permission for my daughter to participate in the Hebron HS Silver Wings Parents Night Out on December 14, 2019. I agree to and understand that although precautions will be taken to ensure the safety of my child, any injury that may occur during the event is not the responsibility of HHS or the Silver Wings Booster Club.
Release of Liability*
- I agree
HHS Silver Wings Photo Release :
HHS Silver Wings is a community outreach program and may reproduce and publish photographs taken on December 14, 2019. I agree that my child’s picture may be used in connection with articles concerning the Parents Night Out or with advertisement of future clinics.
Photo Release*
- I agree
Total
$0.00
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Name
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Silver Wings Parents Night Out

Register for Parents Night Out #4 – Saturday, December 14, 2019

Hebron High School Gym (entrance on West side of campus, across from 9th Grade Center)

6-9pm – Doors open at 5:45pm

Ages 4-11 (* Must be potty-trained)

$25 for 1st Child – $10 Each Additional Sibling

** Pizza & water will be provided.

Child Information

Parent/Guardian Information

Emergency Contact Information