Little Cubs Waitlist
Parents Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Child(ren)’s names and date of birth(month, day, year)
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What is the date of ideal start? When do you project to no longer need care?
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What days/hours are you in need of?
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Does your child have any allergies? (Please list all food, environmental, or medication allergies.
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Does your child have any diagnosed disabilities, medical conditions, or developmental delays we should be aware of?
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What is your child’s nap routine?
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Are there any special accommodations your child requires?
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Has child(ren) ever been in daycare? If currently in daycare please share a summary of why you are looking to switch.
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Do you have a backup caregiver in case of closures?
*
Thank you!
I will contact you via text if I happen to have an opening for your child(ren).
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