Child Care Registration Form Ymca
Download a blank fillable Child Care Registration Form Ymca in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Child Care Registration Form Ymca with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4YMCA of Central East Ontario
Belleville Branch
Child Care Registration
Date Received
Date Revised
* A Non Refundable $35.00 registration fee is required for all new registrations
Preferred Start Date
Email Address
Child's Name Last
First
Initials
Nickname(s)
DOB YYYYMMDD
Address
Postal Code
Age
School Attending
Program
Toddler
Pre-School
Kids Club
Component
Morning
Afternoon
Full Day
Monday
Tuesday
Wednesday
Thursday
Friday
Days Required
** A Minimum of 2 days per week is required to hold your space**
Mother's / Guardian's Name and Address
Home Telephone Number
Cell Number
Place of Employment and Address
Work Number
Father's / Guardian's Name and Address
Home Telephone Number
Cell Number
Cell Number
Place of Employment and Address
Work Number
Emergency Contact Name and Address
Home Telephone Number
Cell Number
Place of Employment and Address
Work Number
Authorized persons who may pick up child
2
3
1.
4
5
6
Medical Information
Previous communicable diseases, illnesses or injuries
Medical conditions or known allergies
Record of immunization required for full day care spaces
Special Medications / Diets
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business