Your Name (required)

Contact Phone (required)

Your Email (required)

Organization Requesting Nursery Care (required)

Event Name

Are you filling our this form for a single event or for an entire year?
Single EventOngoing Event

What Day is the Nursery Care needed? Please provide date(s), time(s) and approximate number of children

Will Food be offered to Nursery workers if group is having a meal?

Important Information:
- Nursery Care is not automatically granted with each meeting.
- Every attempt will be made to secure adequate child care for meetings and events.
- Applications for Nursery Care must be turned in by the 10th of the month before it is needed. (i.e., if a committee needs child care in September, the application for nursery care must be turned in by August 10th ) This is to allow adequate time to find staff.
- Nursery Care cannot begin before 6:15pm CST during the week (i.e., Monday – Friday).
- Nursery Care is provided in the Child Development Center of the church. Parents are instructed to help us respect and take care of the area (i.e., not letting a child leave with a toy, bringing back a change of clothes if they do not belong to them, etc…)
- Groups are not authorized to arrange their own nursery care using our facilities or employees if the meeting is on-site. All requests must go through the Director of Children’s & Young Families Ministry.
- The Director will notify the applicant if there are no nursery workers available at least one (1) week in advance for any reasons other than illness/family emergency.
- Director will notify organization contact if illness prevents childcare immediately upon learning of worker unavailability.
- If 3 or more requests for nursery care are made and then not used, the group may forfeit its right to have nursery care on days when no other event is going on or charged a fee for no shows. However, Nursery Care will still be available to your group when another group is already meeting.

Applicants Responsibilities:
By acknowledging and submitting this form, I agree to the following terms:
- I will notify the Director of our Nursery Ministry, either in writing ( or by phone (254.634.6363), immediately when we cancel meetings, preferably one (1) week in advance.
- I understand that if I am submitting this form, I will become the liaison between the Director of Nursery Ministry and the group and will facilitate all communication between the two parties.
- I understand that nursery care cannot begin before 6:15pm during the week (i.e., Monday – Friday).

Yes, I have read, understand, and agree with the applicant responsibilities stated above.