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Nursery/Youth Service

Enrollment Form

Dear Parents,

We are so excited you have decided to utilize RDKC Nursery/Youth Ministry. Our Child Care Ministry provides a safe, nurturing and educational environment for infants and toddlers during the worship service.

We also have youth services available for children ages 6-10 all curriculums are age appropriate and consist of the following:

Youth Service Curriculum

• Listening skills that include color words, shapes, animals, transportation, countries, community helpers, health, safety, manners, and memory verse

Bible

• Memory verses

• Adam & Eve

• Abraham

• Noah

• Moses

• Joshua

• Jonah

• Samson

• Samuel

• Ruth & Naomi

• The Three Hebrew Boys

• Daniel

• The Birth of Jesus

• The Good Samaritan

In addition, all children will be provided with an age appropriate progression report so, that you can track how your child is doing.

General information

Child’s Last Name ________________________ First Name ____________________________

Parents’ Name _________________________________________________________________

Nickname (if any) ______________________________ Age ___________________________

Home Address: _________________________________________________________________

Home Phone ___________________________

Does your child have any special medical needs if so please explain: Yes No

Is your child currently potty trained? Yes No

Does your child have any food, pet or outdoor allergies? If yes, please explain Yes No

Does your child have Attention Deficit Hyperactivity Disorder (ADHD)? Yes No

What interest or hobbies does your child have?

All about Me

Complete the Following Questions

I don’t like it when: _____________________________________________________________

I love to: ______________________________________________________________________

I wish I could: _________________________________________________________________

My worst day was when _________________________________________________________

My best day was when __________________________________________________________

I what I expect to from the Youth Department: _______________________________________

_____________________________________________________________________________

__________________________________________________________________

Hobbies: _____________________________________________

Favorite Food: ________________________________________________________________

Signing in & Out Policy

All children must be signed in by an adult and signed by the same adult that signed them in.

Upon entering the nursery/ Youth Ministry you will be issued a number that correlates with your child. In order to sign your child out you must have your number no exceptions. All parents/guardians are asked to pick their children up immediately after service.

Medication Dispensing

Although all Youth Minister & Leaders at RDKC are CPR Certified they are not licensed nurses or physicians. Therefore, any and all medication dispensing your child may need must be administered by his or her legal guardian only. In addition, if your child is sick, we are asking that you not bring your child to the youth department until he or she is well; this is to help minimize the spread of germs.

Disciplinary Clause

Please note RDKC does not believe in spanking or paddling a child however, if your child becomes unruly, he or she will be placed in time out for 5-10 minutes at the discretion of the teacher. If your child continues to exhibit unruly behavior you will be notified immediately, and your child will be banned from RDKC Nursery/ Youth Ministry for the remainder of the service. In addition, if your child exhibits 3 incidents whereby, he or she is removed from the nursery or youth ministry due to in appropriate behavior; he or she will be banned until further notice.

Youth Ministers and Teachers

All youth ministers are thoroughly screened through a criminal background check to help ensure the safety of our children. All teachers, ministers and teachers’ aides are CPR Certified, 18yrs or older and have taken a course on early childhood development.

By signing this document, you agree to adhere to the terms and conditions of this document. RDKC also reserves the right to amend the terms and conditions of this form. In the event the terms and conditions are changed you will be notified within 30 days of the change.

______________________________________ _____________________________

(Parent signature) (Date)

______________________________________ _____________________________

(Child Care Signature) (Date)

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