EmailMe Form - MOMS Fall 2017 Registration

MOMS Fall 2017 Registration

MOMS takes place Tuesday mornings from 9:30 to 11:00am in the Lakeview Church Theater. The term is 10 weeks long starting September 19th until November 21st.

DETAILS
*The fee for the term is $60.00.
Payment can be made ONLINE on the Lakeview Church Give page. https://www.lakeviewchurch.com/give/
- Direct Money to "MOMS Registration"
OR you can bring Cash or Cheque on the first morning and pay at the registration desk. Please make cheques payable to "Lakeview Church".

*Please know that we do our absolute best to accommodate all seating requests, however registrations received after September 12th will be assigned to a table based on availability.

*Please email us at moms@lakeviewchurch.com if you do not receive a welcome email after registering.

*Your child will be cared for as if he or she was our own child and by submitting this form, it is understood by you that caution will be taken by the person(s) in charge to prevent injury, but neither those in charge or Lakeview Church will be held responsible in case of an accident.

DROP-INS
*The weekly drop-in fee is $10.00 - this includes childcare and breakfast.
*All moms dropping in can register upon arrival. A Leadership Team Member will be there to sign you in, take payment and let you know which table you can join, unless there is a friend you are joining who you would like to sit with.

General Information - all fields are required.

Name *
First Last

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Email *

We ask that you provide your email so we can send you reminders about the upcoming weeks during sessions and our newsletter. Your information is kept strictly confidential and will not be shared with anyone.

Cell phone number you can be reached at during the MOMS morning (in case childcare workers need to contact you). *
### - ### - ####

Please list the name of the friend(s) you referred to MOMS this term:

CHILDCARE
*Children are placed in rooms based on their age.
*Please do not bring toys from home.
*Rooms are nut free and no outside snacks are allowed. Animal crackers and water are provided in the Toddler and Pre-School Room. Our Pre-School Room Leaders will sometimes bring in a treat for the children so please ensure you list any allergies below. Ages for rooms are as follows:
~ Nursery is for babies aged 0 to 18 months.
~ Toddler room 19 months to 2 years.
~ Pre-School Room is 3 to 5 years.

Please list your children's information below.

FIRST CHILD

Name

Age

Does this child have any allergies?
Yes (please list below)
No

Allergies

SECOND CHILD

Name

Age

Does this child have any allergies?
Yes (please list below)
No

Allergies

THIRD CHILD

Name

Age

Does this child have any allergies?
Yes (please list below)
No

Allergies

FOURTH CHILD

Name

Age

Does this child have any allergies?
Yes (please list below)
No

Allergies

TABLE ASSIGNMENTS
*Table seating is assigned and we do our best to accommodate requests.
*Registrations received after September 12th will be assigned to a table based on availability.

Is there a friend you would like to be seated at the same table with for the term? *
Yes
No, I am new to MOMS
Doesn't matter

If yes, please list her name. If no, welcome to MOMS!

Friend's Name

ADDITIONAL INFORMATION

How did you hear about the Lakeview MOMS Ministry? *
Have attended before
Through a friend
Our Facebook Page
Our Blog
Lakeview Church Info Folder
Lakeview Church Website
Other (please list below)

Other

Do you have a loving Mom, Dad, Auntie, Grandma, Gramdpa or family friend that would be interested in helping in childcare? They do not have to commit to all 10 weeks! We are grateful for any time someone is able to give. *
Yes (please list below)
No

If yes, please list their name and a phone number they can be reached at.

Name/Phone

Is there anything else you would like us to know?

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