*1.How many kids do you have?(Required.)

1

2

3

4

Other (please specify)

2.Children's names and ages

First child

Second child

Third child

Fourth child

3.Children's allergies

First child

Second child

Third child

Fourth child

4.parent information

parent #1 phone number

parent #2 phone number

If I cannot get in contact with parent call (name and number)

5.General information

Food notes

Discipline do's and dont's

Bed time notes

If the child(-ren) need fed, where can I find the food/make it?

Extra notes

6.Children’s intrests

*7.Your name(Required.)

*8.What is your address(Required.)