MMO-2020
Trinity Lutheran MMO Summer Session 2020
June 16 to July 30
Tuesday, Wednesday and Thursday mornings 9 to 11:30 $75.00 a week
2 mornings 9 to 11:30 $55.00 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 16……………Here Comes The Sun__________
June 23……………4th of July_____
July 7…………….We are Going Camping_____
July 14…………….Five Little Monkeys____
July 21…………… Teddy Bear Picnic ________
July 28…………
_________
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. Yes no
Please attach photo
