Request edit access
Childcare Services
Free childcare services will be provided during the build day construction. The dates for this FREE childcare are July 10 - 15th, 2019. While there is no cost for this service, we do ask that you pre-register your child(ren) so we have the ability to plan accordingly. Children must be ages 3 and up and MUST be potty trained. All areas will need to be completed for your child(ren) to attend during the build days of Scout Park.
Email address *
Parent Name (First & Last) *
Your answer
Parent Name (First & Last)
Your answer
Address *
Your answer
City *
Your answer
Zipcode *
Your answer
Child 1 (First & Last Name) *
Your answer
Age (Child 1) *
Your answer
Food Allergies? (Child 1) *
Please explain, if none please type N/A. *
Your answer
Child 2 (First & Last Name)
Your answer
Age (Child 2)
Your answer
Food Allergies? (Child 2)
Please explain.
Your answer
Child 3 (First & Last Name)
Your answer
Age (Child 3)
Your answer
Food Allergies? (Child 3)
Please explain.
Your answer
Emergency Contacts and Schedule Agreement
Please name two people that your child can be released to in the event of an emergency or as requested by the legal guardian of the child. You will be called first unless otherwise indicated.
Name (First & Last) *
Your answer
Address
Your answer
Phone Number *
Your answer
Relationship *
Your answer
Name (First & Last) *
Your answer
Address
Your answer
Phone Number *
Your answer
Relationship *
Your answer
Schedule Agreement Days/Sessions Child Will Attend (Initial all that apply)
Please select the times and days you will need childcare to assist in the building of Scout Park.
Monday June 10, 2019
Tuesday, June 11, 2019
Wednesday, June 12, 2019
Thursday, June 13, 2019
Friday, June 14, 2019
Saturday, June 15, 2019
Devices Agreement
For the safety and wellbeing of all of the children, I understand that devices (i.e., i-Pads, phones, laptops, etc.) are not allowed to be brought or used in any way during their childcare.

If my child has a cell phone, my child is to keep the phone on silent in his/her backpack at all times. If my child needs to call me, my child will use the school phone only. If I need to call my child, I will call the phone number provided to me.

I understand that my child will be expected to follow this agreement.

I will not hold Hazel Park Schools liable for any damaged and/or broken devices as this policy has forbid the use of those technologies.

I agree to explain this agreement to my child in advance.

Please type your first and last name on the line below that you acknowledge the Device Agreement. *
Your answer
Photography and Permission
Photos are to be used for documentation of the Scout Park Build activities.
Please select one. *
By typing my name below, I have acknowledged all the above information. I give my consent for my child to attend the free childcare provided by Hazel Park Schools during the build days of Scout Park, as stated above. *
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Hazel Park School District. Report Abuse - Terms of Service