REGISTRATION FORM

DATE NIGHT/FUN NIGHT FOR KIDS - 10.22.16

SATURDAY, OCT 22 - 6:00-9:00PM

COST: $5 per child for food & entertainment.

LOCATION: 13661 Jupiter Rd #301b, Dallas, TX 75238

If you or someone you know is married w/ children then they need to hear about this event. It is a special night for spouses to connect or for singles for our community.w/ kids to have a break. 

Drop off and sign in begins at 5:30PM - Child pick up ends no later than 9:30PM

Email any questions to Desarae Balerio at balerio.desarae@yahoo.com


Name *
Name
Phone *
Phone
EXAMPLE: Jane (7 yo), John (5 yo), Michael (3 yo).