Vineville UMC - PMO Registration Form

PMO REGISTRATION FORM

Parent’s Morning Out (PMO)

Vineville United Methodist Church

PMO Registration Form

Tuesday and/or Wednesday 9:30-1:00

See PMO Handbook online for registration fees. Mail registration fee to:
Vineville United Methodist Church,
ATTN: Reese McCurry
2045 Vineville Ave.,
Macon, GA 31204

Child's First Name:
*
Child's Last Name:
*

Child's Birthday
*

Mother's Name:
*

Mother's Contact No:
*

Father's Name:
*

Father's Contact No:
*

Address:
*

Email Address:
*

Emergency Contact:
*

Emergency Phone No:
*

Allergies Special Instructions or Medical Information:
*

Doctor's Name:
*

Doctor's Phone No:
*

What day or days?

What are your expectations from this program?

How did you learn about VUMC's PMO Program?

Why did you choose VUMC's PMO?

Would you mind sharing how you will be using your time while your child is at PMO?

Do not enter anything in this field:

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