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Nursery Care Registration Form
Faith Community Church Fort Atkinson, WI
For questions, contact Jackie Lyon: (920) 563-4730
July 27th - July 31st, 2026 - 9:00am to 12:15pm
For children birth - 35 months
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* Indicates required question
Email
*
Your email
Parent(s) First and Last Name(s)
*
Ex. Bob and Sally Smith
Your answer
Address:
*
Your answer
City:
*
Please enter full city name (Fort Atkinson)
Your answer
State:
*
Please enter state as 2 digit code (WI)
Your answer
Zip:
*
Your answer
Cell Phone:
*
Please enter as: (XXX) XXX-XXXX
Your answer
Home Phone:
Please enter as: (XXX) XXX-XXXX
Your answer
Nursery care is available only for children of VBS volunteers and Moments for Moms attendees.
Where will you be during VBS?
*
VBS Volunteer
Moments for Moms
Required
Other adults who are allowed to pick-up your child:
First and Last Name:
Your answer
Relationship to child:
Your answer
First and Last Name:
Your answer
Relationship to child:
Your answer
Register children on the next pages - Click NEXT below
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