Choose Your Session(s) *
Please try to be certain you can make a session before registering, because space is limited. We're excited to see you!
Parent's Name *
Parent's Name
Home Address *
Home Address
Name of 1st Child Attending *
Name of 1st Child Attending
Name of 2nd Child
Name of 2nd Child
Name of 3rd Child
Name of 3rd Child
I hereby give my consent as the parent/guardian of the above named child/ren to attend/participate in the Mornings with Mommy program at Illumine Church, 1262 Riverchase Blvd., Rock Hill, SC 29732. My child and I hereby release, indemnify, and hold harmless the church, its employees and 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 Illumine to take and use photos and/or video of my child for crafts, keepsakes, or promotional purposes in any type of media and understand that I will not be compensated for any such use. *
I hereby give my consent as the parent/guardian of the above named child/ren to attend/participate in the Mornings with Mommy program at Illumine Church, 1262 Riverchase Blvd., Rock Hill, SC 29732. My child and I hereby release, indemnify, and hold harmless the church, its employees and 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 Illumine to take and use photos and/or video of my child for crafts, keepsakes, or promotional purposes in any type of media and understand that I will not be compensated for any such use.
Please type your name in the box below, agreeing with this consent form. Thank you!