PARENTS

Night out

Drop your kids off at Clubworx for a fun filled night of:

Movies, Crafts, Games, Activities, Pizza

Get your holiday shopping done, go out on a date.. 🛍️

Hang with friends, or enjoy a night out in yourself.. 🍷

All while knowing your kids are in a fun, active, and safe environment. 🤗

Kid's should be

• Age 3-12
• Must be potty trained
• And list their allergies if there are any

Date and Time

Friday, 5 - 8pm
• Dec 2nd - Happy Feet Theme
• Dec 9th - Snow Buddies Theme
• Dec 16th - Polar Express Theme

Register Your Kid/s

Parents Night Out

Product Name

How many children do you plan to drop off?(Required)

Date of Drop off(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact Name(Required)

Emergency Contact Number(Required)

Child's Info

Name 1

Birthday 1

Allergies 1

2 Children

Product Name

Price:

Name 1

Birthday 1

Allergies 1

Name 2

Birthday 2

Allergies 2

3 Children

Product Name

Price:

Name 1

Birthday 1

Allergies 1

Name 2

Birthday 2

Allergies 2

Name 3

Birthday 3

Allergies 3

4 Children

Product Name

Price:

Name 1

Birthday 1

Allergies 1

Name 2

Birthday 2

Allergies 2

Name 3

Birthday 3

Allergies 3

Name 4

Birthday 4

Allergies 4

5 Children

Product Name

Price:

Name 1

Birthday 1

Allergies 1

Name 2

Birthday 2

Allergies 2

Name 3

Birthday 3

Allergies 3

Name 4

Birthday 4

Allergies 4

Name 5

Birthday 5

Allergies 5

Total

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Consent(Required)

I agree to the Waiver and Assumption of Risk and Refund Policy

Name

This field is for validation purposes and should be left unchanged.