2025-26 Playgroup Registration (Birth-3)

Child Information

Please complete 1 form per child.

Child Name

This address will receive a confirmation email

Phone

*This information will be used to notify caregivers/parents of any playgroup cancellations

Address

Age

Under 1 1 2 3

Birth date

Medical Concerns/Allergies Yes

Please explain

Learning or Emotional Considerations Yes

Additional Information

Parent/Caregiver Information

Please provide information for the parent or caregiver that will be accompanying the child to playgroup.

Adult Name

Relationship to the child

Phone Number (if different from above)

Email (if different from above)

Church Information

Please indicate your church relationship

Member of Good Shepherd Attend Good Shepherd Little Blessings Preschool family We currently attend a different church Other

I would like more information about Little Blessings Preschool

yes no

I would like information on upcoming events within Children, Youth and Families ministry

yes no

I would like information on membership at Good Shepherd

yes no

Consent to Photography Use

yes no

for congregational purposes only*

I consent that my child has permission to participate in all children's ministry activities, under supervision. Good Shepherd Lutheran Church and its personnel will not be held responsible for accidents or personal injury arising there from. *

yes

Description

Children ages 3 and under, along with their care giver, are invited to join us on Tuesday mornings from 8:30-9:30am in the Verona campus gym during the school year: Sept 16-May 19. Story time, open gym, activities and music are led by our Children's Ministry Director and Music Coordinator. We follow the VASD calendar for any closings/weather related cancellations.

Please register so we can anticipate how many activities and supplies to have for each child. Contact Emily Gold with any questions: egold@gslcwi.com

2025-26 Playgroup Registration (Birth-3)

Description

Please Fix the Following