2024-2025 MomCo Registration

Parent Information

Parent's/Guardian Name:

Address:

Parent's Email:

This address will receive a confirmation email

Phone:

Birthdate

Only register children who will be in the nursery during meetings (even if it's occasionally, such as off days from Kindergarten). Children NOT using the nursery (elementary or preschool age) do not need to be added here.

**Children attending PUMC Preschool on Wednesday mornings do not need to register for the nursery as MomCo meetings will only occur if PUMC Preschool is in session. **

Child #1

Child's Name

Birthdate

Gender

Male Female

Allergies:

Child #2

Child's Name

Birthdate

Gender

Allergies

Child #3

Child's Name

Birthdate

Gender

Allergies

Payment

Please check the session you will attend; e.g fall/$30.00. If you are attending both fall and spring, check the fall and spring session/$50.00.

Please check the session you will attend:

Photo Consent

Powell UMC has my permission to use print or electronic photos of my child while participating in church sponsored events. Children will not be identified by name in any photos:

Permission to use photos

Internal: (Inside building only): YES Internal: NO External: (Internet, Instagram, Website): YES External: NO

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

1st and 3rd Wednesdays of the month, 9:15am-11:30am

Please fill out this form with your session payment and click submit.

2024-2025 MomCo Registration

Description

Please Fix the Following