KIDS' CHURCH – NURSERY Registration (Birth to 3 years) 2026-27

Preferred Service

Child Information

Name

Do you have a favorite nickname for your little one? Let us know and we'll make sure to use it!

Nickname

Birthdate

PARENT / GUARDIAN CONTACT INFORMATION

Is the Parent/Guardian or Significant Other a Member of FPLC? *

Yes No, but want to become a Member Not sure

Primary Parent / Guardian - first and last name

This address will receive a confirmation email

Mobile

Address

Have you moved to a new address within the past 2 years?

Yes No

Other Parent / Guardian / Emergency Contact- first & last name

Email (other)

Mobile (other)

Address (other - if different from primary)

Occasionally we take pictures during special events and post them on social media or our website.

I acknowledge your use of my picture. Please do not include my picture.

Do you have any concerns you would like our Director of Children's Ministries to know about or contact you about? Please let us know below.

If you have more children to sign up, please click SUBMIT below and select one of the registration links.

Description

Please take a few minutes to fill out this Nursery Registration form for each child who is under the age of 3 as of September 1, 2026. We update our records yearly.

KIDS' CHURCH – NURSERY Registration (Birth to 3 years) 2026-27

Description

Please Fix the Following