The Village Fosters Childcare Registration
This is where we can keep contact information and any pertinent information to the safety and well-being of your child. All information will be stored safely with Callie Rivera and any pertinent information relayed to your child's caregiver. 
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Child's Name *
Child's Pronouns *
Required
Child's Birthdate
MM
/
DD
/
YYYY
Child's Adult's Name *
Relation *
Phone Number *
Email
Child's Adult's Name
Relation
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Phone Number
Email
List any other adults authorized to pick up/drop off (Must be 18+)?
Does this child have any allergies? If yes, please specify. *
Where are you registering this child? *
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