EmailMe Form - St. Luke's Church Childcare Request Form

Meeting/Event Name: *
Meeting/Event Date *
MM / DD / YYYY
Start Time: *
HH : MM AM/PM
End Time: *
HH : MM AM/PM
Sponsoring Organization: (i.e. Church, Choir, WOSL, etc.) *
Please provide a brief description of the meeting/event: (i.e. Worship Service, Evensong, Meeting, other) *
Number of children expected. *
1 - 5
6 -10
10 +
Not Sure
If you are not sure please send an email to our Nursery Superintendent at nursery@stlukes-sa.net within 5 days of your meeting/event.
Does this include any infants or toddlers? *
Yes
No
Not sure
If you are not sure please send an email to our Nursery Superintendent at nursery@stlukes-sa.net within 5 days of your meeting/event.
Please provide us with any additional information you feel we should know. *
If you need to cancel or change your request in any way, please send an email to our Nursery Superintendent at nursery@stlukes-sa.net, at least 3 days before the event.
Contact Information
Group/Organization Name: *
Your Name: *
First Last
Phone *
### - ### - ####
Email *