Timberline Childcare Enrollment Form

This form must be submitted to the Childcare Department at least
one week prior to the scheduled event.
Enrollments received under the 7 day requirement will be accomondated the first time,
ONLY if space is available 15 minutes after the start of event.

Enrollment Guildlines

1. The attached form must be submitted to the Childcare Department at least one week prior to the scheduled event. Enrollments received under the 7 day requirement will be accommodated the first time, ONLY if space is available 15 minutes after the start of event.

2. If you will not be bringing your children on any scheduled night, please inform your leader as early as possible.

3. For the safety of everyone; children who are not feeling well, or showing signs of illness, will not be allowed in Childcare.

Some signs of illness are:
Coughing/Sneezing
Runny nose or eyes (green or brown mucus)
Fever of 99 or higher, within the last 24 hours
Vomiting and/or diarrhea occurring within the last 24 hours
Inflamed mouth or throat/Trouble breathing
Red or matted eyes
Infected skin patches
Unusual fatigue or irritability
Any possible contagious situation

These policies have been provided for the care and safety of everyone. The information you provide allows us to staff and plan for your children.

Thank you for following these guidelines.

*

I have read and understand the enrollment guidelines

Group Information

Leader's Name (First and Last Name) *

Ministry Group Name *

Meeting Day of the week *

Meeting Time *

Attending Parent(s) Name(s)

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Phone *

Alternate Phone

Family Email Address

Attending Children's Information

First Name

Last Name

Birth Date

Age

Grade

Sex

Allergies

First Name

Last Name

Birth Date

Age

Grade

Sex

Allergies

First Name

Last Name

Birth Date

Age

Grade

Sex

Allergies

First Name

Last Name

Birth Date

Age

Grade

Sex

Allergies

Children who are not feeling well, or showing signs of illness will not be allowed into Childcare.
Please do not bring children who have been ill within the last 24 hours.

*

I have read and understand the illness guidelines

If you will not be bringing your children on any night please inform your leader as early as possible.

*

I have read and understand the cancellation guidelines