• Child Care Application Form

  • If you want your child to be care by someone else, please fill out this form.

  • Child Info

  • To whom your child care is given?

  • If your child wish to go to someone else in between the care period, refer the second person.

  • Consent to medical care and treatment of minor children.

    I give permission that my child,

  • may be given first aid/emergency treatment by a the child care licensee and/or qualified staff at :