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Monday, January 22, 2018
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Confirmation Sent to
(First Name)     (Last Name)   
 
Email 
 
Address 
 
City       State       Zip 
 
Phone Number 
 
Church       Association 
 
Church Phone 
 
 
MOM AND ME LITTLE                        MOM AND ME
(girls completing grades K-3)               (girls completing grades 2-6)
June 24-25                                     June 16-18
July 15-16
 

Child 1
 
Full Name       Age   Grade        
 
Address 
 
City       State       Zip 
 
Child's T-Shirt Size (Youth and Adult Sizes are Available)
YS     YM     YL     S     M     L     XL     XXL
 
Mom's T-Shirt Size (Youth and Adult Sizes are Available)
YS     YM     YL     S     M     L     XL     XXL
 
 
 Parent's Names 
Emergency Phone Number
Phone
Type
(H,W,C,)
Mom   Mom   
Dad   Dad   
Other   Other   
 

Please list the name of the adult accompanying the child, adults's t-shirt size, and adult's relationship to the child below.

Child 2
 
Full Name       Age       Grade      
 
Address 
 
City       State       Zip 
 
 Child's T-Shirt Size (Youth and Adult Sizes Available)
YS     YM     YL     S     M     L     XL     XXL
 
Mom's T-Shirt Size (Youth and Adult Sizes are Available)
YS     YM     YL     S     M     L     XL     XXL
 
 
Parents' Names Emergency Phone Number
Phone
Type
(H,C,W)
Mom Mom  
Dad  Dad   
Other  Other   
 
 
Please list the name of the adult accompanying the child, adult's t-shirt size, and adult's relationship to the child below.

 Child 3
 
Full Name      Age       Grade 
 
Address 
 
City      State      Zip 
 
Child's T-Shirt Sizes (Youth and Adult Sizes Available)
YS     YM     YL     S     M     L     XL     XXL
 
Mom's T-Shirt Size (Youth and Adult Sizes are Available)
YS     YM     YL     S     M     L     XL     XXL
 
Parents' Names Emergency Phone Number
Phone
Type
(W,H,C)
Mom Mom
Dad  Dad 
Other  Other 
 
 Please list the name of the adult accompanying child, adult's t-shirt size, and adult's relationship to the child below.

Child 4
 
Full Name       Age       Grade 
 
Address 
 
City       State       Zip 
 
Child's T-Shirt Sizes (Youth and Adult Sizes Available)
 YS     YM     YL     S     M     L     XL     XXL
 
Mom's T-Shirt Size (Youth and Adult Sizes are Available)
YS     YM     YL     S     M     L     XL     XXL
 
Parents' Names Emergency Number
Phone
Type
(W, H, C)
Mom  Mom
Dad  Dad 
Other  Other 
 
Please list the name of the adult accompanying the child, the adult's t-shirt size, and the adult's relationship with the child.