MMO Summer Session 2017

MMO

      Trinity Lutheran MMO Summer Session 2017

                                           June 20 to August 1

     Tuesday, Wednesday and Thursday mornings 9 to 11:30 $70.00 a week

                               2 mornings 9 to 11:30 $50.00 a week

Lunch Bunchers 11:30 to 1:30 ..($10.00 a day) …Late Show 1:30 to 3:00 ($ 10.00)

 

Registration

 

Name…………………………………………………………………            Age________________________

Address_______________________________

             _______________________________                    

Cell #______________________

 

Phone____________________

Class presently attending__________________________

Allergies___________________________________________________________________

Food Sensitivities____________________________________________________________

 

In Case of emergency:

Name……………………………………………….Phone#

Name……………………………………………….Phone#

 

I give my permission for my child ……………………………to receive Emergency Medical Treatment

 

Please Circle the weeks you are interested in participating and on the line next to it fill in the number of days 2 or 3

 

June 20……………Here Comes The Sun__________

June 27……………4th of July_____

July 11…………….We=re Going Camping_____                         

July 18……………..Five Little Monkeys____

July 25…………….Going Buggy________

August 2…………..Teddy Bear Picnic_

 

 

Please complete and return with the fee for the first week of participation before May 1st

 

Weeks participating_______________   Amount due___________

 

 

Please complete the reverse side

 

 

 

 

 

 

    Trinity Lutheran Nursery School & Mothers= Morning Out

 

Child=s Name_________________________________

 

Class_______________________________________

 

Emergency Contact information:

In the order of notification

Name                       Relation                          Phone number

1.___________         __________________        ______________

2.___________         ___________________      ______________

3.___________        ____________________     _______________

People Permitted to pick up your child from school:

Name                       Relation                            Phone

1._____________       __________________        _________________

2._____________      ___________________        ________________

3._____________      ____________________       ________________

4.____________       _____________________      _________________

 

Allergies:__________________________________________________

Food Sensitivities_________________________________________________________

Does your child have asthma? yes or no  

Does your child have an inhaler ? Yes or no       Does your child have an epi pen? yes or no

 

e mail address___________________________________________________

 

 

I give my permission for my child_____________________, to have her photo taken at school for our facebook page and web page.

 

Please attach photo