Nursery Request Form Page

Age Requirements for Nursery: Birth to 5th grade, unless prior approval has been given.

A minimum of 2 children are required to reserve a nursery. We also require at least
2 weeks’ notice prior to the date when a nursery is required. Nursery Director Helena
Manning 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:
Nursery Director Helena Manning
678-867-7518
Name:*
First Last
Phone:*
Email:*
Reason for Nursery Request:*
Event Date:*
Date Format: MM slash DD slash YYYY
Event Start Time:*

: HH

MM
Event End Time:*

: HH

MM
Is this a Recurring Event?*
Start Date:
Date Format: MM slash DD slash YYYY
End Date:
Date Format: MM slash DD slash YYYY
List Any Dates Off During This Time:
Number of Children Expected:*
Names and Ages of Children:

(Due 7 days Prior to Event)
If Event is Scheduled During Mealtime, Will Meals be Provided for Workers?*
- Yes
- No
Authorizing Staff Member:*
Name
This field is for validation purposes and should be left unchanged.