St. Christopher Mother's Day Out Enrollment Form 2021/2022

To register your child, please follow these steps:

1) Review the St. Christopher Mother's Day Out Program Information and policies.

2) Print out the St. Christopher Mother's Day Out Medical Form and have it signed by your doctor.

3) Complete the form and pay the registration fee.

4) If you have more than one child to register, you will need to fill out a separate form for each child.

If you have any questions, please contact our director, Tami Martinez, at tami@stchrischurch.org
Program Information & Policies:
Please review the St. Christopher Mother's Day Out Program Information and Policies for 2020-2022 by clicking here.

Medical Form:
Please download the St. Christopher Mother's Day Out Medical Form for 2020-2022 by clicking here.
Child's Information

Please note:  If you would like to put your child on the waitlist, please complete the form and choose "Waitlist Only" for the payment method at the bottom.
 
 
 
 
 
 
Parents' Information

Please put n/a for fields that don't apply.
 
 
 
 
Person(s) other than parents authorized to pick up your child:

 
 
 
 
 
 
Any persons NOT authorized to pick up your child:

 
Person(s) to contact in case of emergency if parent or guardian cannot be reached:

 
 
 
 
 
 
 
 
 
 
Medical Information

Get the 2021-2022 Medical Form by clicking here.
 
 
Program Information & Policies

Review the Program Information and Policies by clicking here.
Please select all that apply.
 
Payment

 
 
 
 
 
 

Description

To register your child, please follow these steps:

1) Review the St. Christopher Mother's Day Out Program Information and policies.

2) Print out the St. Christopher Mother's Day Out Medical Form and have it signed by your doctor.

3) Complete the form and pay the registration fee.

4) If you have more than one child to register, you will need to fill out a separate form for each child.

If you have any questions, please contact our director, Tami Martinez, at tami@stchrischurch.org