Emmanuel’s eMoms is a group of moms with school-aged kids that meet twice a month for encouragement and support. eMoms meets 9:30am – 11:00am on the 1st and 3rd Tuesdays each month from September through April. Childcare is provided for birth – 5th grade if requested at registration.

Registration is online and the earlier you register, the easier the check-in process!

The top portion of this form is about you as the mother.

If none, leave blank.
If none, write "none".
If unmarried, leave blank.
If unmarried, leave blank.
What is the best way for us to reach you in the event of a last minute cancellation or delay of eMoms?

The following fields are about your child(ren). Please complete every field for each child.

Please list any medical or allergy information we should know. For example, "my child has a seizure disorder", "my child requires the use of a wheel chair", etc.
Please list any medical or allergy information we should know. For example, "my child has a seizure disorder", "my child requires the use of a wheel chair", etc.
Please list any medical or allergy information we should know. For example, "my child has a seizure disorder", "my child requires the use of a wheel chair", etc.
Please list any medical or allergy information we should know. For example, "my child has a seizure disorder", "my child requires the use of a wheel chair", etc.
Please list any medical or allergy information we should know. For example, "my child has a seizure disorder", "my child requires the use of a wheel chair", etc.
Please list any medical or allergy information we should know. For example, "my child has a seizure disorder", "my child requires the use of a wheel chair", etc.
For which child(ren) do you want childcare? Please list the # corresponding with the children you've listed above, i.e. C#1, C#5, etc. If none, please write "none".
I acknowledge and understand that photos and video may be taken. These will be used for promotional and recap purposes during church services, our website and social media pages. Emmanuel will never tag your child by name or disclose their location.
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