Fall 2020 IN-PERSON Programming Questionnaire
Dear Parent,

You AND your caregiver(s) should read our reopening plan in detail before submitting your interest. https://www.kidsatworknyc.com/policies-health-safety/

Please note we are currently enrolling children over 12 mos only. To be placed on our waiting list for infants, please email info@kidsatworknyc.com.
Email address *
Parent FULL Name: *
Parent Phone Number: *
Parent Mailing Address: *
Child 1 FULL Name: *
Child 1 DOB: *
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Child 2 FULL Name: (if applicable) Siblings will be placed in the same group. Please note only children older than 12 mos can enter Kids at Work at this time.
Child 2 DOB:
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YYYY
Please list any allergies your child(ren) may have: *
Please list any and all underlying health conditions your child(ren) may have: *
Please provide the following information for any adults that will accompany your child to class.
Your family should plan to send the SAME adult to classes each week, with very few exceptions. A maximum of one adult per child may attend class at a time. Adults (including parent listed above) will need to undergo an orientation and registration process in order to attend, which means that last minute changes in caregiver to an unknown person may not be possible. We recommend you fill in the below with any and all adults (besides parent listed above) who may attend with your child. Please list second parent below if applicable. Parent is responsible for notifying their caregiver that parent has shared their personal information below with Kids at Work. Parent will be notified via email before Kids at Work initiates any communication/orientation with below individuals. Parent can add adults at any time, but please be aware that onboarding can take up to a week. Please ensure that your caregiver feels safe attending our programming before committing to classes!
Adult 1 Name *
Adult 1 Email Address *
Adult 1 Phone Number *
Adult 2 Name (if applicable)
Adult 2 Email Address (if applicable)
Adult 2 Phone Number (if applicable)
Adult 3 Name (if applicable)
Adult 3 Email Address (if applicable)
Adult 3 Phone Number (if applicable)
I need to add more adults, so please contact me.
Clear selection
Are you interested in... (Please note that Kids at Work does NOT allow drop offs at any time, as we are not a licensed child care center.) *
Required
ONE HOUR NON-SEPARATED PROGRAMMING ONLY: Most groups will have a sensory art and music format. Kids at Work may be able to engage our partners to provide classes in soccer, dance, yoga, and Spanish if there is enough interest. Please describe your interest in that below.
ONE HOUR NON-SEPARATED PROGRAMMING ONLY: I'd like my child to attend programming with the SAME cohort of children: (subject to availability and please note tuition rates below)
Clear selection
Please check all times that work for your schedule. Please consider that unregistered siblings are not allowed at class. Kids at Work recommends listing all times except for meal and sleep times in order to have the greatest possibility of being fit into a consistent group. *
Required
Do you have your own group of children formed? If so, please list participants. All participants must complete their own questionnaire.
Pricing will be approximately $80 per child, per hour for all groups, billed monthly. Does this pricing structure fit with your budget? *
Required
Thank you for taking the time to participate in this survey. Kids at Work will reach out to you with information on which group you've been placed in, as well as next steps!
We miss all of you and your kids and hope to see everyone in person again as soon as we can. Stay safe and healthy!
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