Mornings with Mommy New Registration Parent's First Name * Parent's Last Name * Phone Number * Email Address * How many children will be with you? * 1 2 3 4 5 Name and Age of Children (1 per line) * Select a Date * Do any of the children have allergies or other medical concerns we need to be aware of? * How did you hear about us? * Do you have a home church? If yes, where? * Are you looking for a church? * Yes No Would you like more information about Risen Savior? * Yes No Would you like to receive more information about our school, Risen Savior Academy? * Yes No How would you like to pay? * Pay in Advance Via PayPal Pay in Person at Event (Cash Only) I hereby give my consent as the parent/guardian of the above named child/children to attend/participate in the Mornings with Mommy program at Risen Savior Lutheran Church at 14605 59th Ave E, Lakewood Ranch, FL. My child and I hereby release, indemnify, and hold harmless the church, 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 Risen Savior to take and use photography and/or video of my child for crafts, keepsakes, or promotional purposes in any type of media and understand I will not be compensated for any such use. PLEASE TYPE YOUR NAME IN THE BOX BELOW AGREEING TO THIS CONSENT FORM. * If you are human, leave this field blank.