Foster Care Respite Night Registration

We are so excited to serve your family! At Pathway we use an electronic check-in system for kiddos, Infants-12th grade, for different events. Please complete this form, before the upcoming Respite Night, and we will have your info entered into our check-in system. Then you'll be able to check-in at any check-in kiosk for any Pathway event using the last 4 digits of your phone number or your last name. 

If you have any questions please email us at fostercare@pathway.church.

*Address Line 1
Address Line 2
*City
*State/Province/Region
*Zip/Postal Code
*Which Respite Night  Date are you registering for? 
*Local Emergency Contact Name:
*Relationship of emergency contact to adult registering:
*Number of children participating in Kid's Night Out?
*Child 1 Full Name:
*Child 1 Date of Birth:
Child 1 Grade:
*Child 1 Gender:
*Is Child 1 in foster care?
*Does child 1 have food allergies that require a special diet?
If yes, please list the child's allergy:
Child 2 Full Name:
Child 2 Date of Birth:
Child 2 Grade:
Child 2 Gender:
Is Child 2 in foster care?
Does child 2 have food allergies that require a special diet?
If yes, please list the child's allergy:
Child 3 Full Name:
Child 3 Date of Birth:
Child 3 Grade:
Child 3 Gender:
Is child 3 in foster care?
Does child 3 have food allergies that require a special diet?
If yes, please list the child's allergy:
Child 4 Full Name:
Child 4 Date of Birth:
Child 4 Grade:
Child 4 Gender:
Is child 4 in foster care?
Does child 4 have food allergies that require a special diet?
If yes, please list the child's allergy:
Child 5 Full Name:
Child 5 Date of Birth:
Child 5 Grade:
Child 5 Gender:
Is child 5 in foster care?
Does child 5 have food allergies that require a special diet?
If yes, please list the child's allergy:
Child 6 Full Name:
Child 6 Date of Birth:
Child 6 Grade:
Child 6 Gender:
Is child 6 in foster care?
Does child 6 have food allergies that require a special diet?
If yes, please list the child's allergy:
*Do you need a Respite servant to contact you concerning special accommodations?
Submit Form