Thank you for your interest in The Breakfast Club: Mom's Group at Intrepid Christian Church!

You will find our registration forms below. Please complete the registration for you AND for the child(ren) you are registering for child care (if any).

2018-2019 THE BREAKFAST CLUB: MOM'S GROUP REGISTRATION FORM

Welcome! Please complete this form so we can learn about you!

Your Contact Info:

Mom's Group Info:

Your Family Info:

Please list your child(ren)'s name(s) and birthdate(s):

Membership Fees:

Please visit www.pushpay.com/pay/intrepid to pay your membership fees. Choose "MOMS" from the dropdown menu.

Fall Semester: $20.00
Spring Semester: $20.00
($5.00 discount if year is paid for in full by 09/01/18)
Fall Childcare: $55.00 for 1 child
Spring Childcare: $55.00 for 1 child
($5.00 discount if entire year is paid for in full by 09/01/18)
$30.00 for each additional child after one (no discounts on additional children)

 

2018-2019 CHILD CARE REGISTRATION FORM

Family Information

Emergency Information

Special Needs and Instructions; Allergies

Please note the following:

  • Your registration and child care placement for your children is complete when applications and fees are received
  • The per-semester childcare cost is for 1 child. For each additional child, the child care cost is $30/semester.
  • Refund policy: Due to meeting planning, no refunds will be given for the Fall Semester. If you pay for the entire year in advance ($140), up to $50 of your Spring Semester fees may be refunded if your registration is canceled by 12/11/18. Due to planning purposes, we are not able to give refunds for the Spring Semester after this date.

I have read the above Mom's Group fee payment information. I understand that in order to maintain my Mom's Group registration, my registration fees and semester dues must be submitted according to the schedule specified.

Child Care Service Commitment:

In an effort to keep child care costs as low as possible, we ask Moms with children registered in child care to sign up for one hour (half a meeting) per semester in a child care classroom. Sign-ups will take place at the first meeting of each semester.

Photo Authorization

Photos may be taken during The Breakfast Club: Mom's Group and Child care events for inclusion in Intrepid/Intrepid Mom's Group publications or promotional materials. Please complete the following information for the children you are registering in child care:

I give my permission for the following child(ren) to have his/her photo taken and included in Intrepid/Intrepid Mom's Group publications or promotional materials. I also give permission for my photo to be taken for use in Intrepid/Intrepid Mom's Group publications or promotional materials.

Thank you for completing this registration form!

Don't forget to pay your tuition and childcare fees (if applicable) by using the site: www.pushpay.com/pay/intrepid