Ooltewah United Methodist Church

OUMC Mother's Day Out

Mother’s Day Out At OUMC

We are excited to announce a 2 day Mother’s Day Out program. The program operates Tuesdays and Thursdays from 9:30-2:00.

We are currently accepting applications for children, ages 6mths to 4 years.

Registration forms available at the nursery check-in desk on Sunday mornings, the church office, or on-line.

Need more information….

contact Allison Groves@ 238-9216, 238-4300 or allison.groves@ooltewahumc.org

Mother's Day Out Application - School Year of 2008-2009

* Required

First Name *

Last Name *

Email Address *

Address Line 1 * Address Line 2
City *	State *	Zip Code *

Child's Name *
Child's Gender *
Child's Birthdate & Age *
Child Lives With...
Mother's Name/Address/Phone (if different than above)
Father's Name/Address/Phone (if different than above)
Person (name/address/phone number) to be notified in case of emergency (other than mother/father) *
Names and phone numbers of up to 4 persons other than parents/guardian to whom the child may be released
Physician name and office number *
Allergies/Special medical conditions/Medications being taken
Insurance Company
Subscriber ID
Group #
For the School Year of 2008-2009 I am enrolling my child for... *

This facility is not required to be licensed by the State of TN as a child-caring agency.