Name *

First Name

Last Name

Please select which session you are registering for. *

Friday, March 28, 2025

Are you a Texins member? *

Yes

No

Building Name or Location *

NOTE: TI Family Memberships, Contractors, Co-locaters & Retirees should choose "TEXINS"

DMOS5

DMOS6

Kilby East

Kilby West

Research East

Research West

RFAB

SC Building

Sherman

South Building

South Campus - Forest Lane

TEXINS - TI Family Memberships, Contractors, Co-locaters & Retirees

Please choose your form of payment below. *

Payroll Deduction (REQUIRED for TI Employees and TI Family Members). I would like to purchase Parent's Night Out through payroll deduction. By selecting this option you are authorizing Texins to proceed with a payroll deduction charge for Parent's Night Out. Payroll deduction will occur on the date of the event.

Credit Card (REQUIRED for Co-locaters, Contractors & Retirees). Please provide credit card payment at the front desk at Texins Fitness Center on or before the event. If payment is not provided by the deadline your child(ren) will not be able to participate in Parent's Night Out.

Would you like to receive notifications about upcoming youth programs? *

Yes

No