(Formal Version – Ages 0–3)
I hereby grant permission for my child to participate in the church nursery program during worship services and authorized church activities. I authorize church staff and approved volunteers to supervise, care for, and provide reasonable assistance to my child.
I acknowledge and understand that nursery areas are monitored and recorded by video for the safety and protection of children, volunteers, and church leadership.
I consent to my child being present in areas under video surveillance.
3. Discipline & Behavior Policy Acknowledgment
I understand:
• Physical discipline is not permitted.
• Incidents involving biting or aggressive behavior will be documented.
• I will be notified of incidents on the same day.
• After three documented incidents involving my child, my child will be dismissed from the nursery for a period of one (1) month.
• Continued aggressive behavior after return may result in further review of nursery participation.
I agree to partner with the church in addressing behavioral concerns.
4. Health & Medical Authorization
I confirm my child is not currently experiencing symptoms of contagious illness.
In the event of a minor injury, I authorize basic first aid.
In the event of a medical emergency, I authorize the church to seek emergency medical treatment for my child if I cannot be immediately reached.
5. Assumption of Risk & Release of Liability
I understand that while the church takes reasonable precautions to provide a safe environment, participation in nursery activities involves inherent risks, including but not limited to minor injuries from play, interaction with other children, or accidental falls.
On behalf of myself and my child, I voluntarily assume all risks associated with participation in the nursery program.
I hereby release, waive, discharge, and hold harmless the church, its pastors, employees, volunteers, agents, and representatives from any and all claims, liabilities, demands, or causes of action arising out of or related to participation in the nursery program, except in cases of gross negligence or willful misconduct.
6. Agreement to Abide by Nursery Policies
I acknowledge that I have read, understand, and agree to abide by all nursery policies and procedures established by the church.
