Child's Name (please give preferred name)
*
First Name
Last Name
Child's gender identity
*
Please Select
Male
Female
Non-binary
Prefer not to say
Age of Child as of 5 June (Children over 12 not permitted)
*
Select One:
*
Please Select
Toilet Trained
Diapers/nappies
Any allergies?
If any allergies, do any of these require an epi-pen or similar emergency treatment?
Child's special considerations
Learning differences, etc...
Any medical conditions the nannies should be aware of?
Any special notes/personality quirks/fears/phobias to note for the nannies?
Parent's Name
*
First Name
Last Name
Is the parent a student member of ICA?
*
Please Select
Yes
No
University/Affiliation of Parent
*
Phone
*
-
Country Code
-
area code
phone number
Email
*
example@example.com
Languages spoken by child
*
Special security object/lovey if any will accompany the child
Give description of what it looks like, what the child calls it, etc...
Back up Emergency Contact at the conference
*
First Name
Last Name
Relationship to child
*
Phone
*
-
Country Code
-
area code
phone number
Back up Emergency contact email
*
example@example.com
Acknowledge Here
*
I understand that I must provide all snacks, meals and beverages (other than water) that I wish my child to be provided while being cared for by Holiday Nannies.
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Child Care Times (In effort to make childcare accessible for everyone, each child may be registered maximum of one 5- hour session and only two sessions per conference)
*
Friday Morning 5 June 8:00-13:00 (USD$35)
Friday Afternoon 5 June 13:00-18:00 (USD$35)
Saturday Morning 6 June 8:00-13:00 (USD$35)
Saturday Afternoon 6 June 13:00-18:00 (USD$35)
Sunday Morning 7 June 8:00-13:00 (USD$35)
Sunday Afternoon 7 June 13:00-18:00 (USD$35)
Monday Morning 8 June 8:00-13:00 (USD$35)
Submit
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