Back Up Childcare Request
Kreative Kidz NC render's back up childcare services to children when needed!

By completing this form you are signing up for a future childcare need where you need care while your child is out of school or daycare. 8 hours of care is included.

Our pricing for this option is $55/day for ages 6 months-4 years old and $30 for ages 5-12 years old (SUMMER SPECIAL THROUGH LABOR DAY).

(Registration should be completed for each child, if more than one child in household attending)

Check us out at to see what our upcoming events are! Prices Vary.

Please contact us via email,, or call/text, 984-244-2373 for questions or concerns!

Payments accepted are cash, credit, or Cash App $KREATIVEKIDZNC.

We look forward to meeting you and providing your peace of mind!
Sign in to Google to save your progress. Learn more
Email *
Date of Back Up Care Need *
Time Duration of Service Need Request
Parent Name *
Child Name *
Child's DOB (Must be 6 months+) *
Parent's Phone Number *
Preferred Method of Contact *
Emergency Contact & Phone Number *
Authorized Representative(s) For Pick Up- Please note we will check their ID
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy