June 12th MWM 11 AM

Summer Fun

June 12th Friday / 11 am - 12 pm Session
Parent/Caregiver's Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
1st Child's Name

First NameLast Name
Child's Date of Birth
2nd Child's Name

First NameLast Name
Child's Date of Birth
3rd Child's Name

First NameLast Name
Child's Date of Birth
Is this your family's first class with us?
Would you like more information about Christ Alone Lutheran Church?
How did you learn about the class?
Any allergies?
Please type your name in the box, agreeing with this consent form. CONSENT: I hereby give my consent as the parent/guardian of the above name child/children to attend/participate in the Mornings with Mommy program from Christ Alone Lutheran Church, classes held at Dana's Studio of Dance located at 465 W. Southlake Blvd, Southlake Texas 76092. My child and I hereby release, indemnify, and hold harmless the church and dance studio, 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 Christ Alone to take and use photography and/or video of myself and my child(ren) for crafts, keepsakes, or promotional purposes in any type of media and understand that I will not be compensated for any such use.
Should be Empty:

Summer Fun