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PHLC Babysitting Event, Apr, 11, 2015, 4-8 p.m.
Event is for children from infant to age 10.
Enjoy an afternoon out while we babysit your children!
The youth of PHLC and their adult mentors will be hosting a babysitting event on Saturday, April 11, 4-8 p.m. Dinner will be provided.
Cost is $20 for the first child and $10 each additional child per family. Please RSVP by Wednesday, April 1, 2015. When replying online, you may bring your payment the evening of the event. Make checks payable to PHLC Youth.
Thank you for your support of PHLC's Youth Program.
Parent Name
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First
Last
Phone
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Cell Phone
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Email
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Child 1
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Age
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DOB
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Child 2
Age
DOB
Child 3
Age
DOB
Special Health Concerns
Dietary Restrictions
Allergies
Requiring Medication?
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Yes
No
If yes, please provide the dose and time to be administered below.
Dose
Time to be Administered
Emergency Contact Name
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Emergency Contact Phone
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