Nursery Check-In
Child's Name
*
First Name
Last Name
Pager Number
*
Person/s Permitted to Pick Up
*
Only the person/s listed will be allowed to pick up your chilid. Siblings 13 yrs or older who are listed will be permitted to pick up.
Food Allergies?
*
Yes
No
Cheerios?
*
Yes
No
Diaper Change?
*
Yes
No, please page me.
Special Instructions
Submit
Should be Empty: