Mom Prom Registration

Ticket Information

You will receive an email acknowledgement once your form has successfully been submitted. Your registration is not complete until you click 'Submit' in the Review and Submit section of this form.

If mom cannot attend, an alternate family member or family friend is welcome. Reservation deadline is January 31, 2020.
If financial assistance is needed to attend, please contact MJ Kyle at (216) 651-0222, ext. 219.

Mother/Guardian Contact Details




Menu Options
  • Mixed Greens with orange segments, Sundried Tomatoes with Champagne Vinaigrette (gf) (df) (nut-free)
  • Roasted Chicken Breast with a Caramelized Shallot Sauce with Garlic Mashed Potatoes, Broccolini and Baby Carrots (gf) (nut-free)
  • Eggplant Roulade- Rolled eggplant filled with spinach and roasted peppers on a polenta topped with chive oil and balsamic drizzle (vegan) (gf) (df) (nut-free)





Seating Arrangements
Guests wishing to sit together should designate a Table Leader and enter her name in the “Table Leader” box. Tables seat eight, ten or twelve people.

We will do our best to accommodate seating requests, but we cannot make guarantees.




Table Information


For seating arrangements, please list the names of the mothers you would like to sit with at your table. All mothers will need to complete registration, but this will help us for planning purposes to ensure tables are assigned correctly.

Billing Information

Billing Address







Payment Information

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