Nursery Registration (Rolling)

Please have a parent or legal guardian complete the below form on behalf of the child.

Personal Information

Full Name

Preferred Name (For Name Tags, Attendance, etc.)

Contact Type

Program Participant

Date of Birth MM/DD/YYYY

Headshot of Child/ Student

Upload (8MB)

Current FF Program

Registered For...

City and State of Birth

Sex

Male Female

Any allergies or medical information we should know?

Learning Differences?

Physical Limitations?

Family Information

We ask the following information formatted in this particular matter for the sake of our parish sacramental records and registration database.

Father's Full Name

Mother's Full Name

Registered at CTK?

If registered at a parish other than CTK, please note name and city of parish.

Primary Parent or Legal Guardian Contact Information

This is the individual that will receive information regarding the program. Please forgive us if the information is redundant for you; we need to provide for a variety of family situations!

Parent or Guardian Full Name

Phone

This address will receive a confirmation email

Address

Additional Parent or Legal Guardian Full Name (If you would like them to receive information regarding the program)

Additional Parent or Legal Guardian Cell Phone

Additional Parent or Legal Guardian Email Address

Non-Parent or Legal Guardian Emergency Contact Name

Relation of Non-Parent or Legal Guardian Emergency Contact to Individual

Non-Parent or Legal Guardian Cell Phone

Non-Parent or Legal Guardian Email

Baptism

If you HAVE received the Sacrament of Baptism, please complete ALL information for this section.

Received the Sacrament of Baptism?

Yes No Received in a non-Catholic church Unsure

Date of Baptism (Month, Day, Year)

Church of Baptism Name

Church of Baptism Address

Copy of Baptismal Certificate

Upload (8MB)

Consent to Participate, Liability Release, Consent to Treat, and Media Release

Please read this document, found under the description section of the form. Know that we care about keeping all individuals at Christ the King safe. Any pictures that we intend to use for community building and advertising will not include children's names.

I have read and agree to the following on the Consent to Participate, Liability Release, Consent to Treat, and Media Release, 2023-2024

Consent to Participate Liability Release Consent to Treat Media Release Please follow up with me because I have concerns regarding this language.

Description

Hello!

We are happy to welcome you and your family to the CTK Nursery Program.

The Nursery at our parish is available during the 9:30am and 11am Masses on Sunday for 1-3 year olds.

We ask all families to complete an initial registration so that we can access your contact and emergency information. There is no fee for this program.

IMPORTANT: Please view our program's release and liability language at this link before completing the registration.

"Copy and Paste" the following link into your browser to view our Consent to Participate, Liability Release, Consent to Treat, and Media Release, 2024-2025: https://drive.google.com/file/d/14MMH0uENQ0avSKjT_gmMMdzza-u419j4/view?usp=sharing

Nursery Registration (Rolling)

Description

Please Fix the Following