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REGISTRATION FORM
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Parent's Name
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Email
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Phone Number
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Address
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Number of Children Attending
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One Child
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Please select the number of children who will attend Mornings With Mommy
Name of First Child Attending
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Age of First Child Attending
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1 year
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Please select the age of this child (#1)
Name of Second Child Attending
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Age of Second Child Attending
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1 Year Old
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5 Years Old
Name of Third Child Attending
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First
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Age of Third Child Attending
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1 Year Old
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4 Years Old
5 Years Old
Do any of your children have allergies or other medical concerns we need to be aware of?
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Dates Attending (Select any that apply)
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September 11, 2025 (Thursday)
September 12, 2025 (Friday)
September 25, 2025 (Thursday)
September 26, 2025 (Friday)
October 9, 2025 (Thursday)
October 10, 2025 (Friday)
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April 23, 2026 (Thursday)
April 24, 2026 (Friday)
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May 15, 2026 (Friday)
May 28, 2026 (Thursday)
May 29, 2026 (Friday)
Do you have a home church?
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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 Ascension Lutheran Church at
23401 23 Mile Road,
Macomb, MI 48042. 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 Ascension Lutheran Church 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 check the box below to indicate your agreement to these terms and click the submit button to register. Thank you!
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