ProMOMenade Mommy & Me Walk
Sign up for our MOTHERS ProMOMenade Mommy & Me Walk on May 24th, 2024 by filling out the form below. Moms with infants and toddlers are encouraged to attend! Feel free to bring snacks and water.
Your name
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Tell us who will be attending (Date of birth and ethnicity are required for each person, including yourself, to register for the event)
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First Name
Last Name
Caregiver or Child?
Gender
Date of birth
Ethnicity
1
2
3
4
5
Primary email
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example@example.com
Phone Number
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is English your primary language?
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I authorize the use of story/photo/video taken of/by me and my child(ren) on May 24th, 2024 for purposes including broadcast, promotions, media, or sales related situations or other uses deemed suitable by Kutest Kids Early Intervention and Parents as Teachers.
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I understand Kutest Kids Early Intervention and Parents as Teachers are not responsible for any personal injuries or allergic reactions that may occur on May 24th, 2024 and I will not attempt to hold them liable if any injuries may occur.
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Register
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