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Babysitting for Staying Grounded in Harrowing Times
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Child Care Reservations are Required!
Babysitting will be provided during the Neuroscience Lecture 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 Monday, February 19th. Please note allergies. Ages 1 to 6 years only.
*
First Name (Primary)
*
Last Name (Primary)
*
Email (Primary)
*
Phone # to use
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:
Sat, September 7 2024 4 Elul 5784