Nursery Registration 2024
Please register your child for nursery care!
Please tell us about your child:
Child's name:
*
Date of birth:
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Please tell us about yourself:
Parent/Guardian's name:
*
Second parent/guardian's name:
Parent/Guardian's cell phone (Please provide a phone number we can use to contact you during the service, if needed, while your child is in our care):
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Second parent/guardian cell phone:
Parent/guardian's email:
*
Emergency Contact (Is there someone else you would like us to call if we have trouble getting in touch with you?):
Consent & Certification:
I give permission for our (my) child to participate in the events and activities related to Sunday school at WPC. In the event that medical treatment is needed and the Parents/Guardians are not available I authorize a WPC employee or volunteer to act on my behalf and authorize treatment for the above chid. Signed:
*
Please list allergies/health considerations:
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Is there anything we should know about your child so we can care for them in the best way possible? (Including any physical, emotional, learning or behavioral concerns)? Please list anything that could be helpful for us to know.
*
I give permission for nursery staff and volunteers to change my child's diaper or assist them in the bathroom.
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Please select one option.
Yes
No, please contact me if my child needs a diaper change or help in the bathroom.
Photo Release
May we have permission to photograph your child & use these photos on our church website, our social media platforms, and/or in the local paper?
*
Please select one option.
Yes
No
Submit
Description
Please register your child for nursery care!
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