Y ACADEMY: Before & After School Care Application

Early Childcare Application

PLEASE NOTE: Submission of this form does not register your child in the Early Childcare program. Please allow up to 3 business days for your application to be processed. Once accepted, you will be emailed the link to register.
ONCE YOU COMPLETE THIS FORM, PLEASE WAIT FOR AN EMAIL FROM THE YMCA WITH NEXT STEPS TO COMPLETE REGISTRATION.
Are you a Branson School District employee*

YesNo
Parent Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.

Student Information

For Pre-K families, when would your child be attending?

AM OnlyPM OnlyBoth AM & PM
Which location will your child attend?*

Cedar RidgeOTC
Does your child have any development or behavioral concerns?*

YesNo
If yes, please explain:
Check all that apply

Is a biterElopesHas aggressive behaviorHas special feeding needs (cannot eat age appropriate foods or independently)Is non-verbal
Has your child ever been dismissed from another childcare center?*

YesNo
If yes, please explain:
*The YMCA welcomes participation by all children of all abilities. Every effort is made to provide reasonable accommodations, however, there may be instances where a child's needs may exceed the parameters of the scope of our program. All requests for accommodations will go through an approval process that takes at least 2 weeks.
APPLICATION ACKNOWLEDGEMENT*

I understand that submission of this form does not guarantee space in the childcare program. YMCA staff will contact me with next steps to register.
Should be Empty:

Early Childcare Application