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Brick Church Nursery Registration

Brick Church provides Sunday morning childcare every week throughout the year beginning at 9:00 a.m. The nursery is staffed by both professional sitters from Babysitter's Guild, as well as parent volunteers. Please fill out the form below to register your child for the nursery. All children must be registered. Contact Erin Keys with any questions.

Child's Name

First*

Last*

Child's Birthday

Date*

Additional Information

List anything else we should know about your child

Parent/Guardian Name(s)

First*

Last*

Home Phone

Cell Phone

Parent Email Address

Email*

Alternate Email Address

Brick Church Membership

Member

Yes No

Dismissal Authorization

Unless written permission is given, my child, listed above, will be picked up by one of the people listed below*

Electronic Signature

Enter initials to sign*

Volunteer!

The nursery depends on parent volunteers throughout the year. Check the box below if you would like to be added to the volunteer email distribution list.