Health Forward Foundation Scholarship and Registration Information
The YMCA will be offering care for children grades K-6. Thanks to the generosity of the Health Forward Foundation, this care will be offered at no cost for employees of the organizations listed below.  Please note that space is limited. Once your form is accepted and confirmed you will receive an email confirmation.

Missouri: KC Care Clinic, Samuel U. Rodgers, Swope Health Services, Vibrant Health, Truman Medical Center, Tri-County Mental Health Services, Comprehensive Mental Health Services, Rediscover, Hope Family Care Center.

Kansas: Vibrant Health, Health Partnership of Johnson County, SW Blvd Family Health Care, Duchesne Clinic,  Wyandot Center, Johnson County Mental Health Center, Mercy and Truth.
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Email *
Kansas and Missouri State Licensing Forms
The Essential Care program is licensed through the states of Kansas and Missouri. Please note once you receive your confirmation it will include state licensing paperwork that must be filled out in advance and accompany your child to the program.
GENERAL REGISTRATION INFORMATION
Child's Name *
Date of Birth *
MM
/
DD
/
YYYY
Address *
City *
State, Zip *
Primary Guardian Name *
Primary Guardian Phone Number *
Primary Guardian Work Number *
Primary Guardian Email *
Primary Guardian Employer *
Primary Guardian Job Title *
Secondary Guardian Name
Secondary Guardian Phone Number
Secondary Guardian Work Number
Which location will your child attend? *
What dates will your child attend? *
Required
SCHOLARSHIP INFORMATION
Has anyone in your household lost a job due to Covid-19? *
Required
What is your current salary? (For reporting purposes) *
Required
Thank you for submitting your information! We will be in touch soon.
For questions or to contact us please call 816.360.3390 or email yclubsupport@kansascityymca.org.
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