Babysitting Intake Form

Babysitting Intake Form

provided by SMC Dance team
One form is required per child to ensure that medical or other important information remains accurate and not mixed up. Thank you for your understanding!

Cost: $5 per child

Payment: due at drop-off. Cash or Check made payable to "SMC Dance Team"

Age: Children must be over 1 year old

Location: Knights of Columbus Building

Times:

Saturday: Drop-off begins at 5:30pm — pick up immediately following the movie

Sunday: Drop-off begins at 1:00pm — pick up immediately following the movie

What to Bring:

Diapers & wipes (if needed)

Change of clothes for younger children

Any personal supplies your child requires

This will be a fun filled evening for the kiddos! There will be a snack selection and kids drinks will be provided. Please feed your child(ren) dinner (Saturday) or lunch (Sunday) before drop-off.

Questions? Contact Megan Compton at 620-704-1913

Please arrive on time for drop-off and pick-up. Thank you for supporting the SMC Dance Team.
Date/Time*

Saturday, October 11th drop-off at 5:30pmSunday, October 12th drop-off at 1:00pm
Child's Name*

First NameLast Name
Child's Age (must be over 1 year old)*
Parent Name*

First NameLast Name
Parent's Phone Number*
Please enter a valid phone number.
EMERGENCY CONTACT Please ensure this person is aware and available to answer calls during the time your child(ren) is/are in our care.

If both parents are attending the movie, please provide an alternative emergency contact.
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
Relationship to Child*
Please include any allergies, medical conditions, or other important details the team should know about your child.
Should be Empty: