Mom Pod Co Hourly Care
To book hourly childcare, please complete the booking form provided below. Fill in all required fields with accurate information about your child, including any allergies, special needs, or specific instructions for their care. Select the desired date and time for childcare, ensuring to indicate the duration of care needed. Once the form is complete, review the provided details carefully before submitting. Our staff will promptly confirm your booking via email or phone, and we will be ready to welcome your child on the scheduled date. If you have any questions or need assistance, feel free to contact us directly. We look forward to providing exceptional care for your child during their visit with us.
Parent/Gaurdian
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Child’s Name
First Name
Last Name
Drop in Care Location
West Valley In-Home Center
West Jordan Play Center
Lehi Play Center
Pop Up Play
Child’s Age
Drop In Play Date and Drop Off Time:
How Many Hours of Drop In Care Would You Like To Book? Reminder: We only book hourly by the half hour. If you need to drop off in a half hour or different minute mark, please book a full hour and notate drop off and pick up time below.
Please Select
1
2
3
4
5
6
7
8
Any Additional Details About Child We Should Know.
By signing below, I acknowledge that I have read and understand the terms and conditions outlined by the Mom Pod Co childcare facility. I understand that while every precaution will be taken to ensure the safety and well-being of my child, the childcare facility and its staff will not be held liable for any accidents, injuries, or incidents that may occur during my child's stay. I authorize the staff to seek medical attention for my child in the event of an emergency. I agree to provide accurate and up-to-date contact information and authorize the childcare facility to use photographs of my child for promotional purposes. I agree to adhere to the facility's policies and procedures and understand that failure to do so may result in termination of childcare services."
Continue
Continue
Should be Empty: