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To register for M&M Kids, complete the online registration form below. The M&M Kids program begins on Wednesday, August 26, from 5:30PM to 7:30PM.
 
M&M Kids Online Registration Form
 
Parent/Guardian Information
Parent/Guardian Name
Street Address
City
State
Zip Code
Home Phone
Cell Phone
Work Phone
Email
 
Child Information - Must be 3 years old by June 1 and potty-trained.
 
Child #1
First Name   Last Name  
Birthdate
(mm/dd/yyyy)   		Age   Last Grade Completed  
 
Child #2
First Name   Last Name  
Birthdate
(mm/dd/yyyy)   		Age   Last Grade Completed  
 
Child #3
First Name   Last Name  
Birthdate
(mm/dd/yyyy)   		Age   Last Grade Completed  
 
Medical Information
Please provide any medical or other information we need to know, including food allergies.
 
Emergency Contact Information
Name Relation Phone
Name Relation Phone
 
Dismissal Information
Who has permission to pick up your child at the end of each day? Name and Phone Number?
 
Photographic Permission
May we have permission to photograph your child?  Yes
May we have permission to use your child’s photograph in church publications for the purpose of promotion?  Yes