Single Moms Day Out - Child Registration

Saturday, December 7th 2:00 - 5:30 pm | Please complete this form for each child who will be attending the Single Mom's Day Out Event on Saturday, December 7th, 2:00 - 5:30 pm.

Dinner will be served for children and mothers at 5:30 pm.
Child Information:

 
 
 
Parent Information:

 
 
 
 
 
 
 
Parent Release

I give permission for my child, whose name are listed on this registration form, to be photographed and videotaped during church activities. My child/children's image may appear in print or online promoting Church of the Lakes activities. This permission form will be kept on file at Church of the Lakes. If I would like to withdraw my permission, I may do so at any time in writing.
In case of emergency, I hereby give permission to transport my child to the nearest hospital/emergency center for emergency medical treatment to be decided by the doctors and supervisors of Church of the Lakes. I will be contacted as soon as possible.
Please select all that apply.
 

Description

Saturday, December 7th 2:00 - 5:30 pm
Please complete this form for each child who will be attending the Single Mom's Day Out Event on Saturday, December 7th, 2:00 - 5:30 pm.

Dinner will be served for children and mothers at 5:30 pm.