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Child-Minding
To access supervised child-minding services, parents in attendance at the community summit must remain in the venue and have cell phone contact.
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* Indicates required question
Child's Name/Children's Names?
*
Your answer
Ages?
*
Your answer
Accessibility Needs?
Your answer
Do any of the children have anaphylaxis or severe allergies?
Your answer
Other relevant information?
Your answer
Parent/Caregiver Name
*
Your answer
Parent/Caregiver Cell Phone
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Phone Number
*
Your answer
Do you agree to the following stipulations:
*
Parent/Caregiver will remain in the venue at all times that any children are in child-minding
Parent/Caregiver will be accessible at all times that any children are in child-minding via cell phone contact.
Parent/Caregiver accepts liability to use child-minding services.
Required
Thank you! See you at the Summit!
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