MMO Registration Online

Please read the following information, then fill-in the form below.
When you are finished with the form, please click the "SUBMIT" link at the bottom of the form.

A copy of your child's immunization records will be required upon entering MMO.

MMO operates Monday, Tuesday, Wednesday, and Thursday from 9:15 AM to 1:00 PM.

A NON-REFUNDABLE REGISTRATION FEE OF $75.00 MUST ACCOMPANY THIS APPLICATION (NO REFUND UNLESS SPACE IS UNAVAILABLE). SPACE AVAILABILITY IS ON A FIRST COME FIRST SERVE BASIS.

Please make checks payable to "Inwood Baptist Church" and write your child's name and "for MMO Registration" on the MEMO line of your check. Bring the check to the Inwood office or mail it to the following address:

Inwood Baptist Church
3700 Lake Wheeler Rd
RALEIGH NC 27603

Child's Name

Date of Birth (MM-DD-YYYY)

Email Address

Address

Home Phone

Mobile Phone

Father's Name

Father's Occupation

Father's Business Address

Father's Business Phone

Father's Mobile Phone

Mother's Name

Mother's Occupation

Mother's Business Address

Mother's Business Phone

Mother's Mobile Phone

List brothers and/or sisters and age

When parents aren't available, we should contact:

Emergency Name

Emergency Phone

Relationship to Child

Child's Physician

Physician's Phone

Any known Allergies?

Any disabilities or additional information your child's teacher should be aware of?

Church you attend

Please indicate the days in which you would like to enroll your child:

Monday and Wednesday
Tuesday and Thursday
Mon, Tues, Wed, and Thurs

SUBMIT - Please click here to send to our MMO Office

MMO Registration Form