EmailMe Form - Dove of the Desert Nursery Childcare Registration

Nursery childcare is offered to infants and toddlers under 3 years of age.

Use this form to register each child in your family for nursery childcare up to age 3.

Please note there are separate forms for Sunday School (Children age 3 through Grade 6) and Youth (Grade 7 through Grade 12).

* Indicates Required Fields

Nursery Childcare is needed for the following worship and/or adult education periods: *

8:00 am

9:30 am

11:00 am

Child's Name *

First Last

Child's Birthdate *

MM / DD / YYYY

Child's Age *

Baptism Date

MM / DD / YYYY

Child's Interests *

Allergies and reactions and/or Health Concerns *

Snack Preferences *

Special Needs: *

Is this a toddler who is being potty trained? *

Yes

No

Register second child or skip to Parent/Guardian field below

2) Child's Name

First Last

Child's Birthdate

MM / DD / YYYY

Child's Age

Baptism Date

MM / DD / YYYY

Child's Interests

Allergies and reactions and/or Health Concerns

Snack Preferences

Special Needs:

Is this a toddler who is being potty trained?

Yes

No

Register third child or skip to Parent/Guardian field below

3) Child's Name

First Last

Child's Birthdate

MM / DD / YYYY

Child's Age

Baptism Date

MM / DD / YYYY

Child's Interests

Allergies and reactions and/or Health Concerns

Snack Preferences

Special Needs:

Is this a toddler who is being potty trained?

Yes

No

Parent/Guardian Name *

First Last

Mailing Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Home Phone

### - ### - ####

Cell Phone *

### - ### - ####

Email

Re-Type Email

Alternate
Contact's Name *

First Last

Alternate
Contact's Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Alternate Contact's
Home Phone

### - ### - ####

Alternate Contact's
Cell Phone *

### - ### - ####

I give Dove UMC my permission to publish photos of my child on the church website and in local media releases, provided no names are released. *

Yes, I give permission

No, I do not give permission

Name of Person
Giving Permission *

First Last

Date Permission Response
is Provided *

MM / DD / YYYY

EMERGENCY CONTACT DURING NURSERY HOUR

In case of emergency,
I will be:

In the Building

Other

If Other, please specify: *

Cell Phone *

### - ### - ####

The Safe Sanctuary Policy (click link) is being updated and will be provided soon.

Please Validate

By filling in the information above and clicking the 'Register' button below, I attest and affirm:

1. the information provided above is true and correct
2. I wish to register my child for Sunday Nursery Childcare at Dove of the Desert UMC