Health Forward Foundation Scholarship and Registration Information
The YMCA will be offering care for children grades K-6. Thanks to the generosity of the Health Forward Foundation, this care will be offered at no cost for employees of the organizations listed below. Please note that space is limited. Once your form is accepted and confirmed you will receive an email confirmation.
Missouri: KC Care Clinic, Samuel U. Rodgers, Swope Health Services, Vibrant Health, Truman Medical Center, Tri-County Mental Health Services, Comprehensive Mental Health Services, Rediscover, Hope Family Care Center.
Kansas: Vibrant Health, Health Partnership of Johnson County, SW Blvd Family Health Care, Duchesne Clinic, Wyandot Center, Johnson County Mental Health Center, Mercy and Truth.
Kansas and Missouri State Licensing Forms
The Essential Care program is licensed through the states of Kansas and Missouri. Please note once you receive your confirmation it will include state licensing paperwork that must be filled out in advance and accompany your child to the program.
GENERAL REGISTRATION INFORMATION
Date of Birth
Primary Guardian Name
Primary Guardian Phone Number
Primary Guardian Work Number
Primary Guardian Email
Primary Guardian Employer
MO Healthcare: KC Care Clinic
MO: Hope Family Care Center
MO Healthcare: Samuel U. Rodgers
MO Healthcare: Swope Health Services
MO Healthcare: Truman Medical Center
MO Healthcare: Vibrant Health
MO Behavioral Health: Comprehensive Mental Health Services
MO Behavioral Health: Swope Health Services; Rediscover
MO Behavioral Health: Tri-County Mental Health Services
MO Behavioral Health: Truman Medical Center
KS Healthcare: Duchesne Clinic
KS Healthcare: Health Partnership of Johnson County
KS: Mercy and Truth
KS Healthcare: SW Blvd Family Health Care
KS Healthcare: Vibrant Health
KS Behavioral Health: Johnson County Mental Health Center
KS Behavioral Health: Wyandot Center
Primary Guardian Job Title
Secondary Guardian Name
Secondary Guardian Phone Number
Secondary Guardian Work Number
Which YCare Site will your child attend?
Linwood Family YMCA
North Kansas City YMCA
Pathfinder Elementary School
What dates will your child attend?
Week of 5/18/2020
Week of 5/26/2020
Week of June 1 (Linwood only)
Week of June 8 (Linwood only)
Week of June 15 (Linwood only)
Week of June 22 (Linwood only)
Has anyone in your household lost a job due to Covid-19?
What is your current salary? (For reporting purposes)
Less than $75,000
Greater than $75,000
Thank you for submitting your information! We will be in touch soon.
For questions or to contact us please call 816.360.3390 or email
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This form was created inside of YMCA of Greater Kansas City.