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Nursery Child Info Sheet
Child's Name
*
Parent / Guardian Name
*
Email
*
Phone Number
*
Date Of Birth
Address
*
Allergies
*
Health Concerns
*
Eating Habits:
Bottle
*
Select an option
Formula
Breast Milk
Milk
Cup
*
Select an option
Formula
Breast Milk
Milk
Juice
Water
Food
*
Select an option
Baby Food
Baby Food Solid Food (snacks may be offered during time of care)
Can your child have his/her picture taken and displayed? *
*
Select an option
Yes
No
Likes/Dislikes
*
Special Instructions or things you would like us to know about your child
*
Submit