Child Care Request Form
For Sundays 4:30-6:30 PM & Wednesdays 6:30-8:30 PM Only
First Name
Last Name
Email Address
Phone Number
Format: 999-999-9999
Ministry Leader Hosting Event
Event Name
Start Date of Event
Format: mm/dd/yyyy
Event Start Time
Format: hh:mm PM
Event End Time
Format: hh:mm PM
Ages of Children
Infant - Walking
Preschool (2-5 yrs)
School-Age (up to 10 yrs)
Name(s) of Infant - Walking
Name(s) of Preschoolers
Name(s) of School-Age
I have read the F-V UMC Rules for Use of the Nursery Area and agree to guidelines set forth