Nursery Request

Please remember that we require a minimum of two weeks notice and 2 children to reserve a nursery. The age requirements are 0 years - 5th grade, unless prior approval has been given. Susan Clark must be notified, in writing, of changes in the number of children no less than 5 days prior to the event, as additional staff may not be available at the last minute.

Contact:

H elena Manning

Nursery Director

678-867-7518

NAME:
PHONE:
EMAIL:
REASON FOR REQUEST:

DATE OF EVENT:	TIME: from to (Please include am or pm.)

Is this an ongoing need?	Yes No
	If yes, START DATE: END DATE: (00/00/00)
	Any dates off during this time?

NUMBER OF CHILDREN EXPECTED:	(Names and ages of children are due 7 days prior to the event.)

NAMES AND AGES OF CHILDREN:

If event is scheduled during mealtime, will meals be provided for workers?	Yes No

AUTHORIZING STAFF MEMBER: