Lectureship Childcare Registration -- Memphis School of Preaching

Child's Name*

First Last

Child's Nickname

Child's Age*

Child's Birthdate

Mother's Name*

First Last

Mother's Cell Phone Number*

Father's Name*

First Last

Father's Cell Phone Number*

Alternate Adult

First Last

Alternate Adult's Cell Phone Number

Alternate Adult Relationship

Which days do you plan to attend the lectureship?

Monday
Tuesday
Wednesday
Thursday

Are there any medical needs?

Food allergies:

REMINDER: a snack is provided in the morning and afternoon.

Does your child have any special needs of which we need to be aware? Please explain.

Is your child potty-trained?

Yes
No

Will your child tell us when they need to potty? Please explain.

Does your child take a nap daily?

Yes
No

What is your child's normal nap time?

What is the best way to comfort your child when he/she is upset?

What is your child's favorite Bible class/children's song?

Favorite toy/game?

May we photograph your child?

Yes
No

May we use photos on social media?

Yes
No

As a way to allow the children to get some fresh air and exercise, we plan to go to the playground behind the apartments, weather permitting. Your child will be supervised always. If your child does not go, they will stay in a classroom. May your child go outside?

Yes
No

Thank you! We are happy to take care of your child/children and hope you enjoy the fellowship and lectures, while gleaning much from God's Word. Please understand that neither Forest Hill church of Christ nor MSOP can be held responsible for any injuries sustained while your child is under our care.

Digital signature:

Please type your full name.