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Budget Class Child Care Registration
Some of the United Way of Dickinson's employees are sponsoring the childcare for the budget class event. You understand that these employees are personally providing the childcare service. United Way is not hiring the providers nor is affiliated with the childcare providers. Please make sure to sign release when dropping off children. All information must be filled out in order to have your children watched. Childcare location 135 sims #209.
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Name or Parent of Guardian
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Phone number of parent or guardian?
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Email of parent or guardian?
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Name children and ages:
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Name of child(ren) and allergy(s):
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Name of child(ren) and medical (asthma, brittle bone disease, heart condition, limited hearing) or mental health condition (ex. autism, adhd, and etc)
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Emergency Contact and phone?
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