MOMS REGISTRATION FORM

Name

Phone

Do you want to be notified of scheduled changes and information via text message.

Yes No

Address

Birthday (month/day)

Home Church:

Please list children requiring childcare:

Name / D.O.B. / Special Concerns:

Emergency Contact & Phone #:

Description

We are looking forward to seeing you this fall! We hope our MOMS group will be a blessing to you and your child(ren). Please fill out the MOMS of LFC Registration Form and click submit.

MOMS REGISTRATION FORM

Description

Please Fix the Following