Childcare Registration Form

Please note the following:

Nursery childcare is between the ages of three months and four years old as requested and confirmed for ministry events. Pre-registration is required in order to secure appropriate coverage. Services are subject to the availability of staff. Registered parents will be contacted prior to the event to confirm attendance.

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Please name the event you are registering for?*

Please list the names and ages of all children 6 weeks to 4 years old in the space below.*

Please list any allergies, illnesses, or concerns.*

Additional Information

Please verify that you are human*