08
December
6:00 pm — 9:00 pm
Bixby’s First Baptist Church
114 E Breckenridge Ave

Bixby, OK 74008 United States
$5.00
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Parent’s Night Out and Children’s Christmas Party

Enjoy a night out while your child(ren) engage in fun activities including GAMES, ARTS & CRAFTS, MOVIE TIME, DINNER and MUCH MORE!

WHO: Children birth through 12 years old

WHEN: Friday, December 8th, 2017

TIME: 6:00 –9:00 PM

COST: $5 PER CHILD

REGISTRATION DEADLINE: December 1st – SPACE IS LIMITED TO 30 CHILDREN!

REGISTER ON-LINE HERE or by phone at 918-370-3344! Last day to register is December 1st!

Parent's Night Out Registration Form

Child's First Name (required)

Child's Last Name (required)

Child's Age (required)

Parent First and Last Name (required)

Your Email (required)

Street Address (required)

Street Address 2

City (required)

State (required)

Zip (required)

Cell Phone (required)

Home Phone (required)

Known Allergies (required)

Name(s) of person(s) who may pick up this child(ren) from Parent's Night Out: (required)

PROGRAM POLICIES & AUTHORIZATIONS
Bixby’s First Baptist Church agrees to provide child care Friday, December 8th 2017 from 6:00 pm until 9:00 pm. This care includes dinner.

I understand that FBC’s supervision for my child begins when my child arrives and is checked in by FBC personnel.

I understand that the FBC’s responsibility for my child ends when an authorized adult or myself has signed out my child.

I understand that I am not to leave my child at FBC unless released by a FBC staff person who is there to receive and supervise my child.

The FBC child care ends at 9:00 pm. Parents need to ensure that their child is picked up before the end of the program.

I understand that my child may watch a G Rated movie.

RELEASE:
I understand that the risk of injury is inherent in any activity physical in nature. I, hereby consent to my child’s/ward’s presence at First Baptist Church. I do, hereby, for myself, my child/ward, heirs and executors forever waive and release First Baptist Church, its employees and agents from any and all claims, actions, demands, rights and damages of any nature whatsoever, that I or my child/ward may have at any time against First Baptist Church, its employees and agents.

AUTHORIZATION FOR MEDICAL TREATMENT OF A MINOR:
I, the undersigned, parent of the above named person, a minor, do hereby authorize First Baptist Church management as agent(s) for the undersigned to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by and is to be rendered under the general or special supervision of any physician and surgeon licensed under the provisions of the Medical Practice Act on the medical staff of any accredited hospital, where such diagnosis or treatment is rendered at the office of said or at said hospital.

It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required but is given to provided authority and power on the part of our aforesaid agent(s) to give specific consent to any and all such diagnosis, treatment, or hospital care which the aforementioned physicians is the exercise of his/her best judgment may deem advisable.

By initialing the policies and authorization statements above and signing below, I acknowledge that I have read and understand the policies/guidelines and agree to abide by them.

Parent/Guardian Signature:

After submitting the registration form, click the link below to pay online with PayPal.

Purchase and Check Out Here

Author: Shirley Pittenger

Shirley Pittenger has been the Executive Assistant, Office Manager, and Digital Communications & Social Media Manager at Bixby’s First Baptist Church since 2009. Shirley is married to Bob Pittenger who is the Community Groups Pastor at the Church at Battlecreek in the Tulsa Metro area. Shirley holds a Bachelor of Music degree from the Baptist College of Florida. She enjoys teaching in the youth group, singing, reading, studying God’s Word, and spending time with her family.

Details

Date:
December 8
Time:
6:00 pm - 9:00 pm
Cost:
$5.00
Event Categories:
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Event Tags:
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Organizer:
Shirley Pittenger
Phone:
918-366-3456