Mother's Together Childcare Registration 2025-2026

Your name *

Email address *

Phone number *

Child's Name: *

Child's Birth Date: *

Does your child have any allergies or medical concerns our team should be aware of? If so please specify here. *

Special Release for Minors *

By clicking here, I hereby grant permission for the above named minor to participate in all children's programs and activities at Community Presbyterian Church. I also hereby release and agree to hold CPC harmless, its constituent organizations, officers, employees and designated volunteers from all liability for damage, illness or injury. I waive any right to compensation or any right that I otherwise might have to limit or control such making or use.

Photo Release

Community Presbyterian Church (CPC) has my permission to use my photograph and video publicly. I understand that the images may be used in print publications, online publications, presentations, websites, social media and video. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

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