Hemel House Child Care Services
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Child Care Search Information
*
Indicates required field
Parent/Guardian Name
*
First
Last
Home Address
*
Phone Number
*
Email
*
Place of Work/School
*
Start Date of Child Care
*
Area of Lethbridge to Search
*
North
South
West
If transportation for school is needed please indicate name of school
*
Days of Care Needed
*
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Needed child care contract times (drop-off and pick-up)
*
Child(ren) Information
1. Child's Name
*
Choose One
*
Male
Female
Birthdate
*
2. Child's Name
*
Choose One
*
Male
Female
Birthdate
*
3. Child's Name
*
Choose One
*
Male
Female
Birthdate
*
Are there any allergies or medical needs?
*
Can the Family Child Care Center have pets?
*
Yes
No
Certain ones (please specify)
Pet limitations
*
Will you be using Child Care Subsidy?
*
Yes
No
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