Childcare Registration

If you register for this category, you must choose at least one of the required items.

Parent Name:
Email Address

Number of Children (Ages 12 and Under)

Please indicate the number of children you are requesting child care for in the quantity selection area.
Associated Adult Program:
Day of Adult Class:
The Adult Program is in:
  • AM
  • PM
Please provide a cell phone number where we can contact you during the event, if necessary. If you do not have a cell phone, please indicate this in the space provided.
Child's First Name:
Child's Last Name:
Child's Gender:
  • Male
  • Female
Child's Date of Birth:
Child's Current Age:
Allergies:
2nd Child's First Name:
2nd Child's Last Name:
2nd Child's Gender:
  • Male
  • Female
2nd Child's Date of Birth
2nd Child's Age:
2nd Child's Allergies:
3rd Child's Frist Name:
3rd Child's Last Name:
3rd Child's Gender
  • Male
  • Female
3rd Child's Date of Birth:
3rd Child's Age
3rd Child's Allergies:

If requesting childcare for more than three children please open a second registration request form after completing this one.

Rules children must obey: -Be Respectful -Be Safe -Be Responsible

Conditions parents must honor: -Keep your cell phone on vibrate. If contacted (or paged), come immediately to get your child; -At the end of each group/class promptly pick up child. -As a courtesy, please call the Child Care Manager at 755-0089 x 156 if your child cannot attended due to illness, etc.

By submitting this form, you agree to uphold the rules and conditions of child care.

There will be a fee of $3.00 per week per child.