Schertz United Methodist Church - Nursery Registration

Today's Date

Child Information

Child's First Name

Child's Last Name

Child's Birthdate

Current Age

Health Concerns / Seasonal or Food Allergies:

Other things we need to know about your child:

Parent / Guardian Information

First Name

Last Name

Phone Number

First Name

Last Name

Phone Number

Emergency Contact

(other than listed above)

First Name

Last Name

Phone Number

Other than the names listed above, who else may pick up your child? This may include an older, responsible sibling.

First Name

Last Name

First Name

Last Name

Is your child currently in diapers?

Yes

No

If your child is currently in diapers, please complete this section.

I give the church nursery staff permission to change my child's diapers. Diapers are changed in the open with another staff member present.

*By not signing below, the church nursery staff will contact you if your child's diaper must be changed.

Parent/Guardian Signature

Is your child currently potty training?

Yes

No

If your child is currently potty-training, please complete this section.

I give the church nursery staff permission to change my child's clothes in the event of an accident.

*By not signing below, the church nursery staff will contact you in the event of an accident so that you may come change your child's clothing.

Parent/Guardian Signature

Contacting You

If we need to get in touch with you, we will TEXT you. We understand that you will need to silence your phone during the worship service, so please have your phone handy so that you will know if we are trying to contact you. Except for the above circumstances, we will ONLY contact you in case of an emergency.

Snacks

We will provide a small snack during your child's stay. If your child has special dietary needs, please let us know.

Schertz UMC Photo Release

Schertz UMC occasionally has the opportunity to use photos to promote the Children's programs in our church. Uses might include: bulletin boards, newsletters, website, and press releases.

I give Schertz UMC permission to include my child (insert child's first and last name)

in photos used for informational and promotional purposes.

Parent/Guardian Signature

I decline permission.

Yes

Today's Date

Parent/Guardian of a Minor Liability Release

I understand that all responsible safety precautions will be taken by the leaders of Schertz United Methodist Church, but the possibility of an unforeseen hazard may exist. I agree and hereby release from liability and to indemnify and hold harmless Schertz United Methodist Church, its leaders, employees, and volunteers, as regards to my child's participation in children's events held at Schertz UMC.

I, (insert first and last name)

being the parent or guardian of (insert child's first and last name)

hereby give consent for my minor to participate in the activities of Schertz UMC. I further agree to not hold Schertz UMC, its leaders, staff, and volunteers liable for injury, harm, damages, losses, or illness incurred.

Parent/Guardian Signature

Today's Date

Church Nursery and Childcare - Child Information Sheet

Child Information

Parent / Guardian Information

Emergency Contact

Other than the names listed above, who else may pick up your child? This may include an older, responsible sibling.

If your child is currently in diapers, please complete this section.

If your child is currently potty-training, please complete this section.

Contacting You

Snacks

Schertz UMC Photo Release

Schertz UMC occasionally has the opportunity to use photos to promote the Children's programs in our church. Uses might include: bulletin boards, newsletters, website, and press releases.

Parent/Guardian of a Minor Liability Release

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