Mom's Time Out Registration form
We are offering a time for you to drop off your children so you can have a "time out."
LIMITED SPACES AVAILABLE!

DETAILS:
Kid's ages 6months to 10 years
10am-12pm on Wednesdays this summer
We are requesting $5/child per week to cover the cost of snacks and activities.
DISCOUNT if you sign up for 4 weeks ($15) or 8 weeks ($30)

Questions? Contact Kristina: kids@pathfinderchurch.com

Child #1 name (First & Last) *
Your answer
Child #1 Age *
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Child #2 name (First & Last)
Your answer
Child #2 Age
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DD
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YYYY
Child #3 name (First & Last)
Your answer
Child #3 Age
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DD
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YYYY
Parent Name (First & Last) *
Your answer
Parent phone number (to contact in case of emergency during the event) *
Your answer
Emergency Contact Name (in case parent is unavailable) *
Your answer
Emergency Contact Phone number *
Your answer
Dates your child will be attending (Select all that apply) *
Required
Anything else we should know about your child? (food allergies, limitations, etc?) *
Your answer
Would you be willing to volunteer to help at a M.T.O.? *
Submit
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