NCDC Family Knowledge Sessions Child Minding Registration - Raising Health Eaters Nov 26th 2018

Childminding Registration for NCDC Knowledge Sessions

Nanaimo Child Development Centre appreciates that all children have differing needs. Childminding here is a social and networking opportunity for your child(ren) as well. We will have play time, crafts, games and healthy snacks during all childminding sessions.
If you are needing childminding in order to support your attendance to our knowledge session - Raising healthy eaters, tips and tricks from a dietitian, please:

Complete one form for each child you will have attending childminding
Complete this form with as much detail as possible
- so our childminding staff can support your child in enjoying their time with us
Check the N/A box or write in each box N/A if a question is not relevant to your child
Make sure we are aware of any dietary restrictions or allergies to food - as lunch and healthy snacks will be provided during childminding time
- Please do not bring private snacks unless your child is on a very specific diet as this does create challenges for childminder with other children.
- We are a nut and peanut free zone please remember to not bring these items into centre
As we will be hosting a dinner for everyone first please try to arrive on time as dinner will be served at 5 pm - We are having a pizza dinner, salads, veggies, fruit.

Thank you for completing this form, you are now registered for childminding during this workshop. If there is a space issue with the group the Family Resource Navigator Program at the NCDC will give you a call to let you know that you are on the waitlist for childminding. If you do not get a call saying that you are waitlisted, please assume that there is space in the child minding room and we look forward to seeing.

If you decide not to make use of the space(s) you have registered for please let us know, by contacting Kimberlee at 250-753-0251 ext. 259 or email her at Kimberlee@nanaimocdc.com. See you soon.

Note: This information is collected solely to support childminding during parent sessions, information will not be shared with anyone or other organizations outside of the staff of the Nanaimo Child Development Centre, working within the Family Resource Navigator Programs.

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* 1. Parents first and last name (as recorded on registration)

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* 2. Contact phone number

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* 3. Child's Age

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* 4. Child's First Letter in their First Name (if you have two children with the same first letter in their name please add second letter of their first name, as we need one form per child filled out please)

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* 5. Does your child have an allergies?

Yes

If yes, please describe all

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* 6. Diet conditions or requirements, favourite snacks?

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* 7. Any health issues or conditions we should be aware of (ie. medications, seizures, asthma, in contact with communicable diseases, etc):

Yes

If Yes, Please list with details on how to address:

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* 8. Is your child a flight risk. (ie: if door is open or we are outside will they climb the fence and run) Our outdoor area is fully fenced but is chain linked fencing.

Yes

If yes, please expand with more details:

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* 9. In regards to toileting:

	Yes	No	N/A
Does your child use diapers or pull ups?	Does your child use diapers or pull ups? Yes	Does your child use diapers or pull ups? No	Does your child use diapers or pull ups? N/A
If yes to diapers, can the childminders change your child?	If yes to diapers, can the childminders change your child? Yes	If yes to diapers, can the childminders change your child? No	If yes to diapers, can the childminders change your child? N/A
If yes to diapers, would you prefer to have a childminder come get you to change your child?	If yes to diapers, would you prefer to have a childminder come get you to change your child? Yes	If yes to diapers, would you prefer to have a childminder come get you to change your child? No	If yes to diapers, would you prefer to have a childminder come get you to change your child? N/A
Is your child in the process of toilet training and needs reminders?	Is your child in the process of toilet training and needs reminders? Yes	Is your child in the process of toilet training and needs reminders? No	Is your child in the process of toilet training and needs reminders? N/A
Does your child independently go to the bathroom?	Does your child independently go to the bathroom? Yes	Does your child independently go to the bathroom? No	Does your child independently go to the bathroom? N/A

Please expand if there is any special instructions childminders should be aware of:

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* 10. Has your child attended daycare/ preschool/school/recreation programs before and have they needed additional support will attending any of those groups? If yes please describe type / level of support?

Yes

If Yes, Please describe type and level of support

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* 11. Please list any calming techniques used at home to help support your child with transitions or during an emotional breakdown/outburst?

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* 12. Please list any additional special instructions concerning your child, you think is important for childminders to know to help them in creating an enjoyable and fun time for your child while in a childminding session. This may include: behaviour, sensory concerns, likes and dislikes etc.?