NC3 Kids

For children through 5th grade

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Child's Name *
Child's Personal Pronouns *
Child's Date of birth *
MM
/
DD
/
YYYY
Child's Age *
Grade entering (2023-2024)  *
What programming do you plan on attending or would like reminders/invites? *
Required
Street address *
City *
State *
Zip *
Child’s Adult (1)  *
Cell/Work # *
Child’s Adult (2)
Cell/Work #

Other Adults who have permission to pick up child from activities (must be 18 or older)

Please include Name, Relationship, and Phone #

In case of emergency, contact

 *
Please include Name and Phone #

Allergies or other medical conditions

 *
Please share all necessary information. Type NA if not applicable
If your child needs special attention for any medical, legal or other reasons, please inform us so that we can take appropriate measures and join in your team effort to best support them and keep them safe. 

May we have permission to photograph your child and use your child’s photograph in any and all forms of New Covenant Christian Church publications (i.e. Church website, brochures, newsletter etc.)

 *

Tell us about your child. Likes, dislikes, your favorite thing about them

Tell us about the best ways to redirect and support your child if they are struggling

Anything else you would like to share?
For Children birth through Pre-K.
When you sign your child in please let staff know the following information that is applicable.
  • If your child is bottle-fed, how many oz do they currently take, and when their next bottle should be?
  • If your child is potty trained or needs assistance using the restroom.
  • Does your child take a pacifier?
  • Does your child prefer to sleep on the stomach or back?
  • How should we put your child to sleep when they are tired? Rock, in a crib with a bottle, in a crib with a pacifier, special blanket/lovey, baby wear if available?
This information helps us ensure the care given to your child is most effective and helps them remain comfortable while with us.
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