Childcare for Emergency Reponders and Health Care Providers- Registration Form
Excell Academy will provide childcare for students currently enrolled at Excell whose parents are emergency responders and health care providers. Transportation will not be provided. Please be prepared to show proof of employment i.e. paycheck stub, work badge, etc.
Parents must register by March 17th by 12pm
Child Care Regular Hours of Operation: Monday-Friday: 8:00 am - 4:30 pm
Healthcare staff as described below:
- Health care providers and systems, including hospitals and clinics
- Post-acute and long-term care facilities, including nursing and assisted living facilities
- Home Care workers
- Personal Care Assistants
- Direct Care and Treatment
Other emergency staff, including:
- First responders
- Personnel providing correctional services
- Essential Court personnel
- Minnesota State Veterans Homes staff
- State and local public health agency employees
- MNsure Navigators
- County financial/eligibility workers
- County case managers
- Or any county staff in emergency management or health and human services
Parent Full Name
Place of Employment
Please specify the hours of childcare needed.
Please indicate if you have before or after care hours needs.
Daytime Phone Number
Work Phone Number
Student FULL Name(s)
Does your child have any health conditions
Does your child take any medications at school?
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This form was created inside of Excell Academy for Higher Learning.