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Child Care Form (North Canton Care and Connect)
Please fill out the questions below so our team can ensure we have proper coverage during the event.
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Email
*
Your email
Caregiver Name(s): (Last, First)
*
Your answer
Date of the Event
*
MM
/
DD
/
YYYY
How Many Children Need Childcare?
*
Your answer
List names and ages of children - ie "Name, 3" "Name, 7":
Your answer
Are there any allergies or additional notes you'd like to pass along?
Your answer
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