620-342-1144 nlccoe@nlccoe.com

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.
  • First and Last
  • Please include month, day and year.
  • First and Last names please.
  • First and Last
  • For mailing purposes only. Please include town and zip code.
  • For informational purposes. Include all emails you would like us to use.
  • Please Include Area Code
  • Please Include Area Code
    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.)
    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?
    I give consent for my child to be photographed for use on this form.