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Mommy and Me

Pre-Holiday Mommy & Me Class
Hot Apple Crumble with Cold Ice Cream & Honey Dish Craft
Sunday, September 18 | 10:30 AM

$25 (when registering in advance or $30 on day of event)
Registration Information
I would like to register for*
Pre-Holiday Mommy & Me ClassI would like to arrange another class with a few friends on another date:
Date (for other class option)
MonthDayYear
Pay Per Session:
Specialty Holiday Session: $35
September 9, 10, 11, 16, 19
Fall Session: $100
Oct 7- Nov 11
Chanukah Session: $35@ 2997 Ocean Parkway
Nov 18, 25
Winter Session: $260
Dec 16- March 24
Passover Matzah Baking Session: $35@ 2997 Ocean Parkway
April 7, 14
Spring Session: $80
May 5- June 2
Child's Information
Child's Name*
First NameLast NameHebrew Name
Age*
School
Parent's Name*
First NameLast Name
Phone Number*
Area CodePhone Number

AddressIf different than billing address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail*
I would like to receive news and updates by email
Facebook NameTo see pictures and updates
Is there any information concerning your child that is important for the directors of Mommy & Me to know?
(ex: asthma, food allergies)
Do you give permission to use photographs of your child in print materials, on our website, emails and facebook?*
yesno
How did you hear about Mommy & Me?*
Payment Information

Payment*

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Total
$0.00 USD
Should be Empty:

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