Nursery Registration Form

Nursery Reservations

Reservations for Monday must be made by 2 p.m. the preceding Friday.

All * fields are required - Partial information will not be accepted. Reservations must be made 24 hours in advance of event. Multiple children may be entered on one form. For drop-in nursery care, please refer to the drop-in guidelines before making a reservation.

Child's Name (1)*
Child 1 Date of Birth*
MM
DD
YYYY
Child's Name (2)
Child 2 Date of Birth
MM
DD
YYYY
Child's Name (3)
Child 3 Date of Birth
MM
DD
YYYY
Parent's Name*
Email*
Address*
Street AddressCityStateZIP Code
Phone*
(205)555-5555
Event Parent is Attending*
Date of Event*
MM
DD
YYYY
Briarwood Member?*
Allergy Information
Other Special Instructions