Flowers Sunday Nursery Registration

- Faith Formation
Contact Us
- Kendall Sole
  
  Baptism Coordinator
  
  346-335-1831

Little Flowers Registration Form 2024 Sunday 10:00 a.m.

We are delighted and honored that you are a parish member and will entrust us to care for your children during Sunday 10:00 a.m. Mass drop-in care.
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- Child’s Information
- Child's Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Parent/Guardian Name REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Release Authorization
- In the event that you lose your “check-in/out” card, your child will only be released to someone listed here and proof of ID will be required. Please list everyone who has permission to pick up your child: REQUIRED Please fill out this field.
- Health Information
- Immunization Records
  It is the policy of the Archdiocese of Galveston-Houston to require all children under the age of five enrolled in early childhood programs to be immunized against vaccine-preventable diseases caused by infectious agents following the immunization schedule adopted by the Texas Department of State Health Services. Please submit your child’s immunization records to Kendall Sole at [email protected]
- Please list any allergies your child has and notes on treatment in the case of an allergic reaction (for example, epi pen and dose, liquid Benadryl, etc). REQUIRED Please fill out this field.
- Please include other any other information you want us to be aware (eyeglasses, speech/cognitive/motor delay, etc) REQUIRED Please fill out this field.
- Emergency Information
  In the case of an injury, a caregiver certified in CPR/First Aid will administer first aid as necessary, and then parents will be contacted by email/phone/text. If a child is seriously injured, we will call 911 and notify parents by phone immediately.
  
  In the case of an emergency evacuation, the first responsibility of staff is to move the children to a designated safe area. Children 24 months or younger, children with limited mobility, or children with special needs (i.e., visual or hearing impairments) will be transported by a caregiver or in an evacuation crib (there are four cribs for evacuation).
  
  In case of an emergency, and as staff and children are relocated, emergency binders, first aid bags, and supplies will be transported to ensure access to parents' contact information.
- Safe Environment
  St. Theresa Catholic Church is committed to providing a safe environment for all our parishioners, especially our children. Therefore, all parish programs abide by the Safe Environment: Protecting God’s Children policies put forth by the U.S. Bishops. All volunteers with regular, ongoing interaction with children must complete CMG Connect training through the Archdiocese of Galveston-Houston. Visit here for more information.
- Emergency Contact
  In the event of an emergency, if parents cannot be reached, please contact this person:
- Name REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Relationship to the Child REQUIRED Please fill out this field. Please enter valid data.
- Please write your name to acknowledge that you have read the information above, and agree to the information laid out REQUIRED Please fill out this field. Please enter valid data.
- Date REQUIRED Please fill out this field. Please enter a date.
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Flowers Sunday Nursery Registration

Child’s Information

Release Authorization

Health Information

Immunization Records

Emergency Information

Safe Environment

Emergency Contact