Parent's Day Out - Fall 2022 Enrollment Form

Please fill out this form and click submit.
 
 
 
 
 
 
 
 
 
 
 

Please list 2 alternate contacts in case you cannot be reached in an emergency:

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Medical Information

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

By typing your name below, you are granting permission for Christ’s Church of Yukon Parent’s Day Out to meet the needs of your child in case of an emergency.  You are also stating your understanding that Christ’s Church of Yukon is not liable for any doctor or hospital charges that may occur while your child is under their care.

 
 

Description

Please fill out this form and click submit.