Nursery Registration

Nursery Registration Form
Name of Child:
Home Address:
Telephone number:
Parent Information
E-Mail Address:
Names of Father & Mother: Location during Sunday Morning activities:	8:30 Worship: Sunday School: 11:00 Worship:
Information:
Please describe your child's eating & sleeping schedule. If there are any dietary restriction or other information (allergies, special needs) we need to know, please explain.
My child or children may be picked up by other adults named here. Please indicate name & relationship to child. Electronic Signature:	Name: Relationship: