Exit Daycare registration form Question Title * 1. Child’s Name Question Title * 2. Child's age Question Title * 3. Parent/Guardian Name Question Title * 4. Parent/Guardian Email Question Title * 5. Parent/Guardian Phone Question Title * 6. Address Question Title * 7. Hours of child care required Full day Half-day afternoon Half-day morning After school Other (please specify) Question Title * 8. Days of the week childcare required (Select all that apply) Monday Tuesday Wednesday Thursday Friday Saturday Sunday Question Title * 9. What allergies does your child have, if any? Question Title * 10. What medication does your child need to take, and at what time, if any? Done