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Youth Babysitting
Information about your child(ren) so we can care for them better! We look forward to seeing your kids on Friday, December 7th from 6-9 pm. If you have any questions, contact Leah Dail at 919-467-1477 or email leah.dail@stpaulscary.org.
Child One Name *
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Age *
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Any food allergies, special needs?
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Anything we should know about your child?
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Child Two Name
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Child Two Age
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Any food allergies, special needs?
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Anything we should know about your child?
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Additional Child(ren)
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Age(s)
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Anything we should know about these children?
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Parents Name(s) *
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Contact Phone Number(s) *
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Secondary Contact Name *
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Secondary Contact Phone *
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Accident Release & First Aid Waiver: I understand that the educational programs are provided by the St. Paul’s Youth Ministry, and understand the inherent dangers involved with my child’s participation in these programs, including the risk of personal injury and/or damage to my child and/or my property while participating in these programs. I authorize and grant permission for a representative of St. Paul’s Episcopal Church to treat minor injuries including scrapes, small cuts, splinters, and insect bites. I authorize and grant permission for a representative of St. Paul’s Episcopal Church to obtain emergency medical care from any licensed physician or hospital and/or medical clinic should my child become ill or injured while participating in educational activities away from home or at other times when neither parent nor guardian is available to grant authorization for emergency treatment. Signed: *
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