Nursery Registration

Please fill out the information below and submit it. Chance will be in touch with you if there are any questions.

Nursery Registration Form

Name of Child:

Home Address:
Telephone number:
Parent Information

E-Mail Address:

Names of Father & Mother:

Location during Sunday Morning activities:

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: