Section 1 of 3
2026 LMDA New Haven Retreat - Childcare Form
Interested in obtaining or offering childcare during the 2026 LMDA Retreat in New Haven? Fill out the form below to either indicate your interest in finding a childcare provider, or to list yourself as someone who is available to offer childcare services.
Please note that filling out this form neither guarantees nor secures childcare services, but that the information will be shared so that those looking for childcare may reach out to people who are available during the retreat.
Email
This form is collecting emails.Change settings
Name
Name
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Are you seeking childcare or offering childcare services?
Are you seeking childcare or offering childcare services?
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
I am seeking childcare providers
Continue to next section
I am offering childcare services
Continue to next section
Add option
or
add "Other"
…
Answer key
(0 points)
Loading...
Section 2 of 3
Seeking Childcare
If you are looking for childcare services during the New Haven retreat, please fill out your information below.
Phone number
Phone number
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
How many children will you be looking to obtain childcare for?
How many children will you be looking to obtain childcare for?
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Age of child/children:
Age of child/children:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Dates/Times care is needed:
Dates/Times care is needed:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Any details, specific requirements, qualifications desired:
Any details, specific requirements, qualifications desired:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Section 3 of 3
Offering Childcare Services
If you are able to offer childcare services to attendees of LMDA's retreat in New Haven, please fill out your information below.
Phone number
Phone number
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Availability during retreat:
Availability during retreat:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Qualifications (CPR certified, etc.) and Experience:
Qualifications (CPR certified, etc.) and Experience:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
If you'd like to upload a childcare resume, you can do so here:
If you'd like to upload a childcare resume, you can do so here:
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Add file
View folder
Allow only specific file types
Maximum number of files
1
5
10
Maximum file size
1 MB
10 MB
100 MB
1 GB
10 GB
View folder
Answer key
(0 points)
Loading...
Do you have any preference for the age of the child/children you watch? If so, please indicate that here.
Do you have any preference for the age of the child/children you watch? If so, please indicate that here.
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Is there anything else we should know?
Is there anything else we should know?
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
(0 points)
Loading...
Link to Sheets
Summary
Question
Individual
Insights
Total points distribution
Loading...
Settings
Responses
Manage how responses are collected and protected
Presentation
Manage how the form and responses are presented
Defaults
Form defaults
Settings applied to this form and new forms
Question defaults
Settings applied to all new questions