Little Learners Discovery Hour
Sign up for the September 17th Event
Email *
Guardian's First Name *
Guardian's Last Name *
Address *
Number of Children Attending *
Name of First Child *
Age of First Child *
Name of Second Child
Age of Second Child
Name of Third Child
Age of Third Child
Name of Fourth Child
Age of Fourth Child
Do any of the children have allergies or other medical concerns we need to be aware of *
Medical or allergy information
Do you have a home church? *
I hereby give my consent as the parent/guardian of the above name child/children to attend/participate in the Little Learners program at Messiah Lutheran Church. My child/children 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 Little Learners.  *
Required
I hereby authorize Messiah 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.  *
Required
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