Parents’ Morning Out Registration

Registration Application

Are you a member of Trinity Presbyterian Church?*

Yes

Is your child currently enrolled in Trinity Presbyterian's Parents' Morning Out?*

Yes

Child's Information

Child's Name*

First Middle Last

Child's Date of Birth*

Age of Child on September 1, 2023*

Parent's Information

Preferred Primary Parental Contact*

First Last

Relationship to Child*

Primary Contact Phone Number*

Primary Contact Email*

Secondary Parental Contact*

First Last

Relationship to Child*

Secondary Contact Phone Number*

Secondary Contact Email*

Address*

Street Address Address Line 2 City State ZIP Code

Medical Information

Please detail any Food Allergies or other medical conditions we should be aware of. Also detail any necessary treatments for the conditions described.

EpiPen Required?*

Yes

IMMUNIZATION FORM:*

I have attached (below) a copy of my child's immunization form

I have turned in a hard copy of my child's immunization form

Attach immunization form here

Max. file size: 20 MB.

Medical Release

I give permission for PMO staff to initiate or contact emergency medical services for medical treatment of my child in case of emergency.*

Please add initials here for approval or type "NO" for refusal.

Preventative Treatment Release

I give permission for PMO staff to apply sunscreens or diaper creams as needed.

Please add initials here for approval or type "NO" for refusal.

Photo & Digital Media Release

I give permission for digital images of my child to be shared on the Trinity Presbyterian Church website, social media sites, and in church publications.*

Tuition & Registration Payments

Tuition is due on the first day of each month that the program is open (August - May). We will charge a $25 late fee for any payments made after the tenth day of the month. Registration Fees are paid once annually and are equal to one months tuition. ($175, $225, or $295) Once we have received your registration application and determine that space is available in the appropriate classroom you will receive an email confirmation that has a link to our online payment portal. You will be able to pay your registration fee online to complete the registration process.

Please choose from the following options:*

3 Days a Week = $295 Per Month

2 Days a Week = (if available) $225 Per Month

1 Day (Wednesday ONLY - if available) = $175.00 / month

Additional Pickup Information

The following adults have permission to drop off or pick up my child at the end of the day:

Name

First Last

Relationship to the child

Drivers License or State Issued ID Number for verification purposes at pickup

Name

First Last

Relationship to the child

Drivers License or State Issued ID Number for verification purposes at pickup

Name

First Last

Relationship to the child

Drivers License or State Issued ID Number for verification purposes at pickup

Name

First Last

Relationship to the child

Drivers License or State Issued ID Number for verification purposes at pickup

Signature*

Print Name

Date Registration Submitted*

Phone

This field is for validation purposes and should be left unchanged.

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Parents’ Morning Out Registration

Registration Application

Child's Information

Parent's Information

Medical Information

Medical Release

Preventative Treatment Release

Photo & Digital Media Release

Tuition & Registration Payments

Additional Pickup Information

UPCOMING EVENTS

TRINITY PRESBYTERIAN