Mommy & Me

Reservation Information

Name/s and age/s of child/ren reserving *

Street Address

City

State

Postal Code

Please let us know a little bit about your child! (Allergies or medical condition?)

How did you find the Mommy & Me program?

First Name

Last Name

Mother's Email *

Mother's Phone *

Father's Name

Father's Phone

Date Attending (for walk-in class)

Reservation Fee(s)

Number of children: Walk-in class

$20.00

Number of children: Fall Session - Sept. 15, 22, 29, Oct. 6

$65.00

Number of children: Winter Session - Dec. 29, Jan. 5, 12, 19, 26, Feb. 2

$95.00

Number of children: Spring Session - April 20, 27, May 4, 11, 18, 25

$95.00

Please consider celebrating your child's birthday or any occasion with us!

Sponsorships

Total

My sponsorship is in honor/in memory of