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.
This form is not for Sunday worship services.
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*
Should be Empty: