MWM: Music and Instruments (11/1)
To register, complete the form below. The registration fee is $5 per family (not per child). Please bring cash or check with you to the session (written out to Bethlehem Lutheran Church). Sessions will be capped normally around 20 children. You will be notified if a session is full or cancelled for any reason. If the session is full, you will be placed on a waiting list int he order that your registration was received.
Email Address: *
Your answer
Parent/Caregiver Last Name: *
Your answer
Parent/Caregiver First Name: *
Your answer
You are registering for November 1st: Music and Instruments
Street Address (if this is your first time attending):
Your answer
City, State, Zip (if this is your first time attending):
Your answer
Phone Number: *
Your answer
Please list the name(s) AND age(s) of the children attending: *
Your answer
Do any of the children have allergies or other medical concerns we should be aware of?
Your answer
How did you hear about our program? *
Do you have a home church? *
If yes, what church do you belong to?
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 Bethlehem Lutheran Church at N108W14290 Bel Aire Ln., Germantown, WI 53022. 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. Please type your full name in the box below agreeing with this consent form. *
Your answer
I hereby authorize Bethlehem 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 if you agree with this consent form. *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service