MMB26 Child Care Registration Form

MMB26 Child Care Registration

We will be Partnering with an amazing Childcare Agency to care for your children this year.
Information of Child
Name

First NameLast Name
Child's age (children under 1 will be required to stay with parent)
Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Gender
Information of Parent/Guardian
Name

First NameLast Name
Relationship
Phone Number (must receive text messages)
Please enter a valid phone number.Format: (000) 000-0000.
Parents will be contacted via text for diaper changing, feeding, or any other special care needs or concerns. Is there a different number for this? If so, type here.
Email Address
example@example.com
Emergency Contact 1
In the event of an emergency, please contact:
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Other people authorized to pick up child from childcare at MMB25
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Medical Information
Preferred hospital
We will feed the children with some form of kid friendly meal and will inform you all on what the meal will be closer to the event date. Please list any of the following: Current medications, medication allergies, food allergies, or chronic health concerns.
Please note that we will not be able to take on any children with any special needs or physical disabilities that require one on one care. We kindly ask that you keep your child with you if so. Do you understand these terms?
If you arrive later than 1:45pm, children on the waiting list will be allowed to check in and your spot may be taken if childcare is at capacity, Do you understand these terms?
If child is unable to stay in childcare due to behavior, feeding needs, etc. Parent/Guardian will be contacted for pickup. Do you understand these terms?
There will be photography and videography at this event. Please click yes if you understand that photography and videography will be taken at the event and used for marketing and media purposes.
Please sign here to signify that you understand and agree to the terms above. We look forward to caring for your beautiful children.
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MMB26 Child Care Registration

Information of Child

Information of Parent/Guardian

Medical Information