• MWO Childcare Registration & Parent Consent Form

    Please complete ONE form for EACH child who will be participating in childcare.

  • Childcare Hours: 9:30 AM–6:30 PM 
    MANDATORY LUNCH BREAK 12:45 PM-1:45 PM

    Ages: 6–13 ONLY

    Children will participate in supervised, age-appropriate activities throughout the day, which may include games, coloring, arts and crafts, group activities, and approved television/media.

    Important Information Before You Begin

    • A responsible parent/guardian must remain inside the GEMS Summit building while their child is checked into childcare.
    • All children must be checked out for lunch from 12:45 PM–1:45 PM.
    • MWO uses a strict matching-wristband system for child pick-up.
    • Final childcare pick-up is from 6:00 PM–6:30 PM.

    ALL children must be picked up no later than 6:30 PM.

    Please carefully review all policies and acknowledgments before electronically signing this form.

  • Parent/Guardian Information

  • Format: (000) 000-0000.

  • Child Information:

  • Child's Date of Birth:*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Allergies, Medical & Dietary Information

  • Does your child have any known allergies?*
  • Does your child have any medical conditions that the childcare team should be aware of?*

  • Supporting Your Child

  • Emergency Contact:

    Please provide an emergency contact ion addition to the parent/guardian completing this form.
  • Format: (000) 000-0000.

  • Childcare Activity Consent

    MWO's childcare program will include supervised, age-appropriate recreational activities coordinated by the Childcare Lead. Activities may include games, coloring, arts and crafts, group activities, and approved television/media.

  • Parent/Guardian Must Remain Onsite

  • IMPORTANT CHILDCARE POLICY

    • The responsible parent/guardian must remain inside the GEMS Summit building while the child is checked into childcare.

    • Children may NOT be left in MWO childcare while their responsible parent/guardian leaves the building.

    • If you need to leave the building for any reason, you must first check your child out of childcare and take your child with you.

    • Your child may be checked back into childcare upon your return, provided childcare is still open.

    • If a child is left in MWO's care without a responsible parent/guardian remaining onsite, MWO will make reasonable attempts to immediately contact the parent/guardian and emergency contact.

    • If MWO is unable to reach a responsible adult or the situation creates a concern for the child's safety or welfare, MWO may contact appropriate authorities or emergency services as necessary to ensure the child's safety.

  • MANDATORY Lunch Check-Out:

    ALL CHILDREN MUST BE PICKED UP FOR LUNCH

  • Childcare will pause during the Summit lunch break from:

    12:45 PM–1:45 PM

    During this time:

    • ALL children must be checked out of childcare.

    • The parent/guardian is responsible for picking up their child.

    • The parent/guardian is responsible for providing their child's lunch.

    • The parent/guardian is responsible for supervising their child during lunch.

    • Children may NOT remain in the childcare area during the lunch break.

    • Children returning to childcare after lunch must be checked back in.

  • Secure Pick Up & Matching Wristband Policy

  • For the safety and security of every child participating in GEMS Summit childcare, MWO will use a matching-wristband system for child pick-up.

    At check-in, each child and their designated authorized pick-up person will receive corresponding identification wristbands. Parents/guardians are responsible for keeping their wristband secure throughout the Summit.

    At pick-up, children will only be released after the childcare team has verified the identity and authorization of the person picking them up.

    Standard Pick-Up Procedure

    • The authorized pick-up person must present the wristband that corresponds with the child's wristband.
    • Please do not transfer, exchange, or give your wristband to anyone who is not authorized to pick up your child.

    Lost or Missing Wristband

    We understand that wristbands can occasionally be lost or damaged. If an authorized pick-up person does not have the corresponding wristband, additional identity verification will be required before the child can be released.

    The individual must:

    • Be listed as an authorized pick-up person on the child's completed intake form; AND
      Present a valid government-issued photo ID that matches the name provided on the intake form.
      The Childcare Lead or designated MWO staff member must verify this information before the child is released.

    A child's recognition of an adult or verbal confirmation alone will not be considered sufficient authorization for pick-up.

    If the childcare team is unable to verify the individual's identity and authorization, the child will remain safely in the supervised childcare area until an authorized pick-up person can be verified.

  • Final Childcare Pick-Up

    FINAL PICK-UP: 6:00 PM–6:30 PM

  • Final childcare check-out begins at 6:00 PM.

    ALL CHILDREN MUST BE PICKED UP AND CHECKED OUT NO LATER THAN 6:30 PM.

    • Childcare services end at 6:30 PM. MWO cannot provide continued childcare or supervision beyond the designated childcare hours.

    • Parents/guardians should arrive at the childcare area with enough time to complete the secure wristband check-out process before 6:30 PM.

    • If a child has not been picked up by 6:30 PM, MWO will immediately attempt to contact the parent/guardian and emergency contact.

    • If MWO is unable to reach the responsible parent/guardian and the child remains in MWO's care beyond the designated childcare period, MWO may contact appropriate authorities or emergency services as necessary to ensure the child's continued safety and supervision.

    • The matching-wristband requirement continues to apply to late pick-ups.

  • Illness, Injury & Emergency Procedures:

    Parents/guardians must remain reachable by phone while their child is checked into childcare.

  • MWO may contact you and require you to promptly return to the childcare area and/or pick up your child if your child:

    • Becomes ill
    • Is injured
    • Experiences significant distress
    • Requires parental assistance
    • Demonstrates behavior that creates a safety concern for themselves or others
    • Has needs that cannot reasonably be managed within the childcare setting

    In the event of an emergency, MWO may contact 911 or appropriate emergency medical services when reasonably necessary and will make reasonable efforts to contact the parent/guardian as quickly as possible.

  • Final Parent/Guardian Consent & Certification

  • By signing below, I acknowledge and agree that:

    • I am the child's parent/legal guardian or otherwise have legal authority to provide the permissions contained in this form.
    • The information provided about my child is complete and accurate to the best of my knowledge.
    • I give permission for my child to participate in the GEMS Summit childcare program and its supervised activities.
    • I have disclosed relevant allergies, medical conditions, dietary restrictions, accessibility needs, and other information necessary to support my child.
    • I understand that I must remain inside the Summit building while my child is checked into childcare.
    • I understand and agree to the mandatory lunch check-out from 12:45 PM–1:45 PM.
    • I understand and agree to MWO's strict matching-wristband security policy.
    • I understand that NO MATCHING WRISTBAND = NO CHILD RELEASE.
    • I understand that final childcare pick-up takes place from 6:00 PM–6:30 PM and that my child must be checked out no later than 6:30 PM.
    • I understand that I must remain reachable while my child is in childcare.
    • I have reviewed and agree to the childcare requirements contained in this form.
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: