Foothills Fellowship Church - CO - Pre-K and Nursery Child Info Form

Please fill out the Pre-K and Nursery Child Information Form Below:

Child's First Name

Child's Last Name

Child's Birthdate

Grade

Parent/Caregiver First Name

Parent/Caregiver Last Name

Parent's/Caregiver's Phone Number

Parent's/Caregiver's Email

Brothers and Sister Names and Ages

Name(s) for approved individuals for child pick up after service ends:

Allergies

Is your child potty trained?

Other (Explain)

Do you give permission for female volunteers to do diaper changes or toileting?

Other Support Areas: (ADHD, Reading, Sight, Hearing or Speech Difficulties, Learning Delays, etc.)

Anything else you would like us to know about your child?

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