Risen Savior Lutheran Church
Learn and Play with Me Registration
Choose One Session:   May 2, 2012, 9:30 - 10:30 - Flowers, Plants, and Trees
May 16, 2012, 9:30 - 10:30 - Under the Sea
May 30, 2012, 9:30 - 10:30 - Zoo Animal Fun
June 13, 2012, 9:30 - 10:30 - Bugs, Worms, and Little Crawlers
June 27, 2012, 9:30 - 10:30 - Flags, Parades, and the U.S.A
First Child's Name:   Age:
Second Child's Name:   Age:
Third Child's Name:   Age:
Please describe any allergies or medical concerns we need to be aware of:  
Parents First Name:  
Parents Last Name:  
Street Address:  
City:  
Zip Code:  
Phone:  
Email:  
How did you hear about "Learn and Play with Me"?  
Do you have a church you are actively involved in?  
I hereby give my consent as the parent/guardian of the above named child/children to attend/participate in the Learn and Play with Me program at Risen Savior Lutheran Church at 625 Otay Lakes Road. My child and I hereby release, indemnify, and hold harmless the church, its employees and/or volunteers from any and all liability from any claim, injury, or loss sustained by or during my child's participation during Learn and Play with Me. I hereby authorize Risen Savior to take and use photography and/or video of my child for crafts, keepsakes, or promotional purposes in any type of media and understand I will not be compensated for any such use.