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Parents Night Out 2021

Ages 5-12

Starting with the October 8th PNO we will now be limiting PNO to 10 children per Friday. Please note: all children and parents must wear masks while in the building!

Contact Information
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First Name
Last Name
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Please provide a contact # for us to reach you while your child is at LHS
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
Waiver Agreement

By completing this registration process you are acknowledging that the parent or legal guardian of the child or children attending the Lynchburg Humane Society Parent's Night Out has read, understood and agrees to this waiver.

I give permission for the Lynchburg Humane Society to use photos of the child attending Summer Camps and Parent's Night Out for Lynchburg Humane Society marketing and other materials.

The Lynchburg Humane Society, Inc. makes no claims or representations regarding the temperament, disposition or health of any animal. I release The Lynchburg Humane Society, Inc. and its agents from any and all injuries and property damage, by any pet. 

I hereby release, discharge, indemnify and hold harmless the LHS and its directors, officers, employees, volunteers, and agents, and their successors and assigns, from any and all claims, causes of action, and demands of any nature, whether known or unknown, arising out of or in connection with my child's activities and interactions during this event and with any animals.

If you would like to still register a child for PNO but do not agree to the use of photography, please proceed with your registration and call Evelyn at 434-448-0088 ext. 142 or email at evelyn@lynchburghumane.org  to let us know that you would not like to have your child's photo used.

Refund policy:  Please contact Evelyn with any refund request.  Any refunds processed will be minus fees incurred for credit card processing.

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mm/dd/yy
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Please select the date you are registering your child for (separate forms required for each event)
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