Mother's Day Out

 

we do not have any opening currently- please call prior to registering online.

$30 registration fee  $15 per day      

MAKE Your PAYMENT by clicking HERE!

Tuesday & Thursday 9AM-2PM

For more information, contact Becky Jenkins

Fill out the Registration Form Below if you are interested in enrolling your child.  You will be contacted by Becky Jenkins once she has received your form.

MDO Registration Form

Child's Gender*

Mother's Address*

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Father's Address

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We attend church regularly*

We are a member of the church we attend

Please list a family member and a friend that we can contact in case of an emergency when a parent/guardian can not be reached.

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Family Member Address*

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Friend Address

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Please list all names and ages of children in the family. Type "none" if this does not apply.

Does child have any Health Issues?*

Does your child have any unusual health issues such as allergies, asthma, epilepsy, etc.? If yes, please list in the box below and provide any information we will need to best care for your child.

Has your child had any type of surgery?*

If yes, please list type and date of surgery below.

Please type your name which serves as a signature signifying that you agree with all terms set forth above.