FCC Childcare Intake Form

Sunday @ 10:30AM | Please fill this form out prior to your child entering our church childcare. A new form must be completed before each childcare stay. Space is currently limited to 5 children (ages 4 and under) each visit.

If ALL of the answers below are NO, your child MAY attend the program.

If ANY of the answers below are YES (excluding fatigue, if it is the ONLY symptom), the child MAY NOT attend the program and should remain home.

A separate form is required for each child.

Children UNDER age 3 are not expected to wear a mask, a mask is recommended (but not required) for children age 3 and older. Masks will be worn by our Childcare Room workers.
 
 
 
 
 
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Description

Sunday @ 10:30AM
Please fill this form out prior to your child entering our church childcare. A new form must be completed before each childcare stay. Space is currently limited to 5 children (ages 4 and under) each visit.

If ALL of the answers below are NO, your child MAY attend the program.

If ANY of the answers below are YES (excluding fatigue, if it is the ONLY symptom), the child MAY NOT attend the program and should remain home.

A separate form is required for each child.

Children UNDER age 3 are not expected to wear a mask, a mask is recommended (but not required) for children age 3 and older. Masks will be worn by our Childcare Room workers.