Lahaina Date Night Request Form Lahaina Kid Zone Maui LLC Date Night Request Form Each Child Must Fill Out A Form Date * Today's Date Responsible Parent Name * First Responsible Parent Name * Last Child's Name * First Child's Name * Last Child's Age * We accept children from 3 to 10 yrs old. Email Address * Phone Number * The number you can be reached at on Date Night What Allergies or Medical Conditions does your child have? * If none write none. I Agree to Read and Fill out the Date Night Waiver Form. * Yes Must be clicked to be Registered for Date Night.