Mornings with Mommy Registration
To register complete the form below. The registration fee is $5.00 per family (not per child). Please bring cash or check with you to the session. Checks may be written out to Ladies of Peace.
Which session or sessions would you like to register for? *
Mornings with Mommy sessions run on the second and fourth Mondays of the month.
Required
Parent's First Name (Mom, Dad, Grandma, Grandpa, or Caregiver) *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Street *
Your answer
City, State *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Number of Children Attending *
Name of First Child Attending *
Your answer
Age of First Child Attending *
Name of Second Child Attending
Your answer
Age of Second Child Attending
Name of Third Child Attending
Your answer
Age of Third Child Attending
Do any of the children have allergies or other medical concerns we need to be aware of? *
Your answer
Do you have a church that you regularly attend? *
Your answer
I hereby give my consent as the parent/guardian of the above named child/children to attend/participate in the Mornings With Mommy program at Peace Lutheran Church at 5039 County Road G, Deshler, OH 43516. My child and I hereby release, indemnify, and hold harmless the church, its employees and/or volunteers from any and all liability from any claim, injury, or loss sustained by or during my child's participation during Mornings With Mommy. I hereby authorize Peace Lutheran Church to take and use photography and/or video of my child for crafts, keepsakes, or promotional purposes in any type of media and understand I will not be compensated for any such use. Please type your name in the box below agreeing with this consent form. *
Please Type your name below to give your consent.
Your answer
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