Mornings with Mommy Waitlist Registration
Beautiful Savior Lutheran Church and School
10265 Bermuda Rd. Las Vegas, NV 89183
morningswithmommylv@gmail.com
Email address *
Parent's First Name *
Your answer
Last Name *
Your answer
Please check any Tuesday 10 a.m. sessions for which you would like to register for the waitlist.
*
*
*
*
*
*
*
*
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
Your answer
Name of Third Child Attending
Your answer
Age of Third Child
Your answer
Name of Fourth Child Attending
Your answer
Age of Fourth Child
Your answer
Name of Fifth Child Attending
Your answer
Age of Fifth Child
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Is this your first time attending Mornings with Mommy? If so, how did you hear about us? *
Your answer
Do any of the children have allergies or other medical concerns of which we need to be aware? *
Your answer
Please enter your cell phone number to receive a reminder text should space become available. *
Your answer
Would you like more information about our other children's programs and our church? *
Would you like information about our preschool? *
This form is to be added to the waitlist for the above selected sessions of MWM. If space becomes available, you will receive a text the day prior to the session. It is very important that you reply to the reminder text in order to be fair to others on the waitlist. Most of you are excellent at responding and we greatly appreciate it! Thank you for your cooperation! Please check below indicating that you agree to the following statement. *
Required
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 Beautiful Savior Lutheran Church and School at 10265 Bermuda Road, Las Vegas, NV 89183. My child and I hereby release, indemnify, and hold harmless the church and school, 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 Beautiful Savior 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 FULL NAME in the box below agreeing with this consent form. *
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service