* Indicates required question

    1. Family Information (Please include children's names, ages, and gender.) *

    2. Parent Phone Number *

    3. Email *

    4. Health Information? Please include dietary restrictions and allergies. *

    5. Co-op will be held one Thursday a month at Mission Bible Church in Minooka from 9am-2pm.

    6. Fees are yet to be determined, however will be based on enrollment. It will be a family fee. More families = less money per family.

    7. The teaching focus will be differing electives. Classes will be parent taught. Please choose which subject area you are confident in teaching. *Lauryn will provide curriculum, if needed, for the subject areas. (Check all that apply)

    8. If you chose “none” above, will you be willing to aide one of the above classes?

    9. We have the opportunity to have a space for the toddlers/babies to hang out and play. Would you be willing to be with the babies while another mom may be leading a class? (The rooms are connected)

    10. Would you like to be enrolled in the Sign Language course?

    11. Do you have any field trip recommendations for the year?

    12. I have read over the Rooted in Faith Cooperative Handbook and will return the signed agreement with my payment, or on the first day of co-op. *