DATE NIGHT

+ FREE CHILDCARE

GOOD TIMES

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Date Night Details

When: Wednesday, February 18, 2026, from 5:30 PM-7:30 PM.
Registration Deadline: 11:59 PM, February 16, 2026.

* Please note that the date night is for Sylvania members, regular attenders, and visitors.

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Comments

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Parent/Guardian Information

Primary Contact*

First Last

Primary Contact Email*

Primary Contact Cell Phone*

Secondary Contact (i.e., Your Valentine's Date)*

First Last

Secondary Contact Cell Phone*

Child(ren) Info

How many of your children will be in childcare?*

* This number only applies to those who are 5th grade and younger. Oasis students should not be included in this number.

Name*

First Last

Child's Age*

Grade Level*

Will this child need his/her food cut?*

Does this child need help eating?*

Does this child need a highchair?*

Please list food allergies and/or special instructions (e.g. "usually takes a bottle at 7pm")?

Child #2

Name*

First Last

Child's Age*

Grade Level*

Will this child need his/her food cut?*

Does this child need help eating?*

Does this child need a highchair?*

Please list food allergies and/or special instructions (e.g. "usually takes a bottle at 7pm")?

Child #3

Name*

First Last

Child's Age*

Grade Level*

Will this child need his/her food cut?*

Does this child need help eating?*

Does this child need a highchair?*

Please list food allergies and/or special instructions (e.g. "usually takes a bottle at 7pm")?

Child #4

Name*

First Last

Child's Age*

Grade Level*

Will this child need his/her food cut?*

Does this child need help eating?*

Does this child need a highchair?*

Please list food allergies and/or special instructions (e.g. "usually takes a bottle at 7pm")?

Child #5

Name*

First Last

Child's Age*

Grade Level*

Will this child need his/her food cut?*

Does this child need help eating?*

Does this child need a highchair?*

Please list food allergies and/or special instructions (e.g. "usually takes a bottle at 7pm")?

Child #6

Name*

First Last

Child's Age*

Grade Level*

Will this child need his/her food cut?*

Does this child need help eating?*

Does this child need a highchair?*

Please list food allergies and/or special instructions (e.g. "usually takes a bottle at 7pm")?

Child #7

Name*

First Last

Child's Age*

Grade Level*

Will this child need his/her food cut?*

Does this child need help eating?*

Does this child need a highchair?*

Please list food allergies and/or special instructions (e.g. "usually takes a bottle at 7pm")?

Child #8

Name*

First Last

Child's Age*

Grade Level*

Will this child need his/her food cut?*

Does this child need help eating?*

Does this child need a highchair?*

Please list food allergies and/or special instructions (e.g. "usually takes a bottle at 7pm")?

Special Notes

Please tell us anything else we may need to know.

DATE NIGHT

+ FREE CHILDCARE

GOOD TIMES

Date Night Details

Parent/Guardian Information

Child(ren) Info

Child #2

Child #3

Child #4

Child #5

Child #6

Child #7

Child #8

Special Notes

Sylvania Church

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(903) 592-1591

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