Child's Info

Child's Info

Dar's Darlings | Contract | Child's Info | Hours and Payment
  
    

Child's Name _______________________________

Birthdate ________________________________

Health Card # ______________________________

Dr.'s Name Address & Phone # ______________________

_________________________________________________________

Child's Home Address & Phone # ________________________________

____________________________________________________

Parents Name ______________________________________

Work Name Address & Phone # __________________________

____________________________________________________

Cell Phone # ________________________________________

Email ____________________________________________

Child's School & Teacher ________________________________

___________________________________________________

Emergency Contact ____________________________________

___________________________________________________

 

Important Information I should Know: