MOMS Club of Coronado | New & Returning Members | Membership and Liability Release Form
All new members and existing members renewing their membership are required to have a current signed membership and liability release on file with MOMS Club of Coronado before attending any activities or programs.
Email address *
Full Name *
Your answer
Address *
Your answer
Phone *
Your answer
Your birthday
Your answer
Children's Name(s) and Age(s) *
Your answer
What playdate groups would you like to be a part of? You can join/drop any time - check as many or few as you like.
Please select all that apply
Add me to this playgroup!
Monday 10a-12p : Toddlers
Tuesday 10a-12p : Mixed Ages
Wednesday 1:45p-3p: Ages 10+ After School Club
Thursday 11:30a-1p : Infants
Thursday 3p-5p : Mixed Ages
Friday 10a-11:30a : Preschool/PreK
AGREEMENT: I, the undersigned, understand that my participation and the participation of any members of my family in any MOMS Club activity or program is completely voluntary, and we hereby give permission for myself and my family to join in those activities or programs. My family shall hold harmless this local MOMS Club. The MOMS Club Corporation, any MOMS Club volunteers or representatives, paid or unpaid, and/or the providers of any activity or program location and/or materials from any liability and/or responsibility for any accident, illness, or injury that occurs during or as a result of any function or program. I accept that the final responsibility for my safety and that of my family rests with me. REQUIRED: PLEASE TYPE YOUR FULL NAME BELOW. *
Your answer
PHOTO RELEASE: I, the undersigned, grant to MOMS Club of Coronado, CA, its representatives and employees the right to take photographs of me and my children in connection with the above-identified subject. I authorize MOMS Club of Coronado, CA to copyright, use and publish the same in print and/or electronically. I agree that MOMS Club of Coronado, CA may use such photographs of me and my children with or without our names and for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising, and Web content. OPTIONAL: PLEASE TYPE YOUR FULL NAME BELOW.
Your answer
INFORMATION RELEASE: I, the undersigned, give permission for MOMS Club of Coronado, CA to share and exchange personal information, including all contact information, with other staff and members of MOMS Club of Coronado, CA for the purpose of providing assistance to me and my family. This may include sharing information about my children’s names and ages. OPTIONAL: PLEASE TYPE YOUR FULL NAME BELOW.
Your answer
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