Reserve Child Care
Please use this form to let us know if you will need child care while participating in the Rise Against Hunger meal packaging event at Reveille UMC on October 1, 2017. Child care is available for children age four and under only. Please include each child needing care on the form below.
Child Name 1 *
Your answer
Child Name 2
Your answer
Child Name 3
Your answer
Child Name 4
Your answer
Age of children *
Child care is available for ages four and under only
Required
Additional information about your child or children (include all ALLERGIES and any special needs and name if multiple children)
Your answer
Your first name *
Your answer
Your last name *
Your answer
Relationship to child *
(Parent, Guardian, Grandparent, etc.)
Your answer
Your email address *
Your answer
Your mobile phone number *
Your answer
Your home phone number
Your answer
Emergency contact name *
You must provide an adult contact other than the parent/guardian already listed.
Your answer
Emergency contact phone number *
Your answer
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