Nursery – Child Registration

CHILD'S INFORMATION


Birthdate: Age:

Gender:

Medication Given for Allergies:

Feed Time: Snacks

Food/Bevarages not to be given:

What calms your baby?

Nap Time:

Naptime needs: PacifierBlanketStuffed AnimalResists Naptime

If applicable:

Is your child potty-trained?YesNo

Behavior Habits
biting nailsbiting otherssucking fingerstantrumsstammering

Does your child:
have any fears?cry easily?play well with others?share?play well by himself/herself?put away toys after playing?help with small household chores?

PARENT/GUARDIAN



Mobile # Home #

OTHERS AUTHORIZED TO PICK-UP YOUR CHILD (16 years or older)

I hereby permission to use my child’s photos without names in publications, on the website and in news releases in regard to any sponsored activity of First Baptist Church of Shallotte.

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