Mornings with Mommy Registration
Complete the form below to register.  The registration fee is $5.00 per family (not per child) per session.  Please bring cash or check with you to the session.  Checks may be written out to Beautiful Savior Lutheran Church.
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Which  session or sessions would you like to register for? *
Please select all that you plan to attend. All sessions begin at 10:00am and end at 11:00am.
Required
Parent's First Name *
Last Name *
Email Address *
Street *
City *
State *
Zip Code *
Phone Number (###-###-####) *
How do you prefer to be contacted to confirm the session? *
Number of Children Attending *
Name of First Child Attending *
Age of First Child Attending *
Name of Second Child Attending
Age of Second Child Attending
Name of Third Child Attending
Age of Third Child Attending
Do any of the children have allergies or other medical concerns we need to be aware of? *
Are you interested in more information about Beautiful Savior Church? *
Liability and Publicity Release
I hereby give my consent as the parent/guardian of the above named child/children to participate in the Mornings With Mommy program at Beautiful Savior Lutheran Church at 3628 W. Johnson Rd., La Porte, IN 46350. 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. 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 name below to give your consent.
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