September-December 2024 Playgroup Registration

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Messiah Playgroup Registration Form.

Messiah Lutheran Church & Preschool

is located at

14920 Hutchison Rd.

Tampa, FL 33625

Building B Christian Life Center (CLC) (Room 3)

Our first FALL class will be September 9, 2024 at 9AM. Activities are designed to be readily accessible to two-year-olds. We could have children from newborn to 4, depending on the group dynamics. Register for Playgroup by filling out the information below:

Email *

Child's Name *

Child's Date of Birth *

Child's Address *

Home Phone number

Home Church (if any)

I give Messiah permission to use photos of my child and myself in future promotional material and/or social media? *

Yes

Allergies or Health Issues we should be aware of:

Name of Adult Participating with child in Playgroup *

Mother's Name & Phone Number

Father's Name & Phone Number

Emergency Contact Name & Number

I give permission for my child to participate in Playgroup at Messiah. *

Yes

Required

Parent Signature *

Date: *

YYYY

A copy of your responses will be emailed to the address you provided.

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