2026-2027 Cub Care Registration

Honeypot
Tricks bots and scammers, if filled hides submit button
FallBoth Summer & Fall
Today's Date

MonthDayYear
*$35 Registration Fee per child
*Family Cap $60
*Registration Fees must be paid to enroll
*Current enrolled families billing accounts must be up-to-date

*If your child has an Allergy, please complete the form in your confirmation email or notify our child care coordinator*

*After submitting your registration you will be taken to our secure payment website to pay the registration fee
Child's Last Name*
Child's First Name*
Child's Nickname*
Child's Birth Date*

MonthDayYear
Home phone*
Format: (000) 000-0000.
Cell phone
Format: (000) 000-0000.
FemaleMale
Home Address*

Street

Street Address Line 2

CityState / Province

Zip Code
Email address (will only be used by Community Education for announcements and reminders, etc.)*

Both parentsSingle ParenMotherFatherOther
Mother's Full Name*
Mother's Birthdate

MonthDayYear
Mother's Employer*
Mother's Business Phone
Format: (000) 000-0000.
Mother's Mobile Phone*
Format: (000) 000-0000.
Mother's Home Phone
Format: (000) 000-0000.
Mother's Home Address
Father's Full Name*
Father's Birthdate

MonthDayYear
Father's Employer*
Father's Business Phone
Format: (000) 000-0000.
Father's Mobile Phone*
Format: (000) 000-0000.
Father's Home Phone
Format: (000) 000-0000.
Father's Home Address

Authorized Pick Up

People listed below have my authorization to pick up my child from the program. I will inform the staff each time a special pick up is necessary.
Name *
Relation to child*
Phone*
Format: (000) 000-0000.
Name*
Relation to child*
Phone*
Format: (000) 000-0000.
Name*
Relation to child*
Phone*
Format: (000) 000-0000.
*Children will only be released from Tiger Time when signed out by an authorized person, parent or guardian. Persons NOT authorized to take the child from the program. (Copies of legal documents must be provided to the program coordinator before any staff person can actively prevent non-custodial parents from picking up their child.)
1.*
2.*
Parent/Guardian Signature*
Date*

MonthDayYear

Emergency Information

Name of friends or relatives to call in case of illness or emergency if you cannot be reached.
Person #1*
Address*
Phone*
Format: (000) 000-0000.
Person #2*
Address*
Phone*
Format: (000) 000-0000.
Physician to be called in an emergency*
Physician Phone*
Format: (000) 000-0000.
Dentist to be called in an emergency*
Dentist Phone*
Format: (000) 000-0000.
Insurance Company*
Policy Number*
I hereby grant permission for Tiger Time staff to take whatever steps may be necessary to obtain emergency medical care if warranted. These steps may include, but are not limited to the following: 1) Attempt to contact a parent or guardian. 2) Attempt to contact the child's physician. 3) Attempt to contact a parent through any of the persons listed in the emergency information you completed for us. 4) If we cannot contact you or your child's physician, we will do any or all of the following: a. call anotherphysicianor paramedics, b. have the child taken to an emergency hospital in the company of a staff member. 5) Any expenses under 4 above, will be paid by the child's family.
Parent/Guardian Signature*
Date*

MonthDayYear

TIGER TIME PERMISSION AND RELEASES
Child's Name*
Date*

MonthDayYear
PUBLICITY PERMISSION
In the event the Tiger Time program students are included in any newspaper, radio, on social media or television publicity, I give permission for my child to be included in the pictures and the release of their name.
POLICY AGREEMENT
I recognize my responsibility to respect the rules of the Tiger Time program as well as my responsibility to help my child respect the rules needed to provide a positive experience for all participants.
RECORDS RELEASE
I hereby authorize (name of school)*
To release a copy of (child's name)*
most recent school records, including but not limited to: immunization and physical exam records, special needs assessments, and IEP's in order to enable the Tiger Time program to better meet the needs of my child.
NON-PRESCRIPTION MEDICATION PERMISSION
Sunscreen (must be provided in a labeled container by parent)Insect repellent (must be provided in a labeled container by parent)Medical supplies: such as band aids, adhesive tape, hydrogen peroxide, antiseptic wipes, etc.
TRANSPORTATION CONSENT
I hereby give the employees of Tiger Time permission to transport my child in a school issued vehicle or by foot to activities within the city limits of Lake City as necessary. I understand that I will be notified in advance of any arranged trips that would involve my child being transported by Tiger Time personnel.
MOVIE/MEDIA RELEASE
I hereby give Tiger Time permission to show my child movies rated G while attending our program.
TOILET TRAINING
Children enrolled should be able to attend to their own personal hygiene. Children attending are required to be toilettrained and able to use the bathroom independently before they begin the program. If your child has an excessiveamount of accidents, the staff will communicate with the parents to see if they can come up with a plan for the childto succeed in toileting issues. If the child continues to have accidents regularly, the child will be suspended until theyare fully potty-trained. We will hold their spot for the remainder of the year (school/summer).

An extra change of clothing should always be packed or in their locker.

Definition of Being Potty Trained

A child is considered fully potty trained when they are able to:

● Recognize the need to use the bathroom and communicate that need to an adult.

● Use the toilet independently, including:

○ Pulling down and pulling up their own clothing.

○ Sitting on the toilet (with or without a seat insert).

○ Wiping themselves to the best of their ability.

○ Flushing the toilet.

○ Washing and drying their hands.

● Stay dry during naps and throughout the day with minimal to no accidents.

● No longer require pull-ups or diapers during the day, except in rare circumstances approved by parentsand the director (e.g., medical or developmental needs).

Being potty trained means the child can manage toileting with minimal adult assistance and is able to consistentlyremain clean and dry while in our program.
Parent Signature*
Date*

MonthDayYear
If your child has any allergies please complete the MN DHS Form DHS-7995A and return to us.
Should be Empty:

Authorized Pick Up

Emergency Information

Cub Care Program Rates:

Scheduling Information

School Day Hours: 5:45 am - 8:00 am / 3 pm - 6 pm

TIGER TIME PERMISSION AND RELEASES

PUBLICITY PERMISSION

POLICY AGREEMENT

RECORDS RELEASE

NON-PRESCRIPTION MEDICATION PERMISSION

TRANSPORTATION CONSENT

MOVIE/MEDIA RELEASE

TOILET TRAINING