Nursery Information and Consent Form The nursery is for children ages birth through 3 years of age. Children will go to Kid's Worship after they turn 4 and become potty trained. Name*First and LastDate of Birth*Please include month, day and year.Guardian's Name(s)*First and Last names please.Mother's Name*First and LastAddressFor mailing purposes only. Please include town and zip code.emailFor informational purposes. Include all emails you would like us to use. Phone Number (Primary)Please Include Area CodePhone Number (Secondary)Please Include Area CodeSibling's Name(s) and Age(s)Diaper Bag Color/Style*Child's Interests/Toys/BooksAllergiesBest Way to Comfort When Upset*Child's DislikesFavorite FoodsOther Information/ConcernsParental Contact* contact me please let my child try to work it out If your child is upset during the service, would you prefer to be contacted and brought back to the nursery, or would you prefer the child try to work it out? (If you prefer that your child try to work it out, we will give him/her 15 minutes before contacting you.)Car Seat* Please allow my child to remain asleep in carrier. Please remove my child from the carrier. If your child arrives asleep in the car seat, would you like the child to remain sleeping in the car seat or to be removed from the carrier?Consent to be Photographed* yes no I give consent for my child to be photographed for use on this form.