2016 Annual Conference Childcare Registration Form
A conference member needing care for his or her child(ren) age 10 or under is asked to provide the information request  The request deadline is May 20.
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Parent(s) Name *
Telephone Number *
Address *
Name of Child *
Age of Child *
Name of Child
Age of Child
Name of Child
Age of Child
Childcare is needed for the following days: *
Required
Special needs or information we need to be aware of?
If the weather is appropriate, is your child(ren) allowed to play outside? *
I understand that meal costs for children aged 3-17 are $4.00 for lunch and $7.00 for dinner (you will need to add this to your registration fee based on need). *
Required
I understand that my child(ren) will be picked up during meal times. *
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