St. Johns on the Lake Play group (Winter session)
Thank you for your interest in participating in a Toddlers and Kids on a Mission Playgroup at St. Johns on the Lake.
you only need to complete the registration once for the entire session.

St. Johns on the lake playgroup
1840 North Prospect Avenue
ST. JOHN'S MONDAY SESSION DATES: 1/7, 2/4, 3/4, 4/1 10:00-11:00am
ST. JOHN'S TUESDAY SESSION DATES: 1/8, 2/5, 3/5, 4/2 10:00-11:00am


The information provided will not be shared with any third party organizations.

Email address *
Preferred Day
Participant Information
Tell us about the child or children attending the event.
Name(s) and Age(s) of Participating Children *
Your answer
Parent/Guardian Information
Who will be accompanying the above child(ren) to the mission.
Parent/Guardian Name *
Your answer
Phone Number *
Your answer
Address *
Your answer
Would you like to be added to our newsletter? *
Waiver & Photo Release
I, the undersigned and/or parent/guardian of the individual(s) named above, do hereby agree to indemnify and hold harmless Toddlers and Kids on a Mission, inc. and its agent from and against any and all liability resulting from participation in the missions listed below. I understand that the mission (s) in which I am enrolling, like all activity programs, has some inherent risk, for which I agree to assume the liability. Furthermore, the individuals named herein are in good health appropriate for the activities in which they will be participating.

For TOAM promotion purposes, photographs may be taken of participants. If you do not wish to have your photo taken, please notify the photographer or instructor. No names or any other identifying information will be shared if the photograph is used, unless requested.

Name *
Your answer
Emergency Contact
Name and phone number for Emergency Contact
Person not attending event
Your answer
Questions or comments
Your answer
Thank You
Info@ToamMke.org l WWW.ToamMKE.org
A copy of your responses will be emailed to the address you provided.
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