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Babysitting ADL Program
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Child Care Reservations are Required!
Babysitting will be provided during the ADL program free of charge. However, in order to properly staff for our children’s safety, you
must register in advance
. Please complete the form below no later than Friday, February 2nd. Please note allergies. Ages 1 to 6 years only.
*
First Name (Primary)
*
Last Name (Primary)
*
Email (Primary)
*
Phone # to use during the program
Additional phone # to use
*
How many children?
Please Select One
1 Child
2 Children
3 Children
*
Child1 First Name
*
Child 1 Last Name
*
Age of Child 1
Please note any allergies:
*
Child 2 First Name
*
Child 2 Last Name
*
Age of Child 2
Please note any allergies:
*
Child 3 First Name
*
Child 3 Last Name
*
Age of Child 3
Please note any allergies:
Wed, January 15 2025 15 Tevet 5785
