House at Pooh Corner
Family Daycare...
Home
Photo Gallery
Online Application
Care Form
Care Form
*Child's Name(s)
*Parents Name(s)
*What days are you seeking care for your child/children?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
I am aware that Weekend Care is an extra $20 per day on top of the weekly total (please check if you are applying for weekend care)
Permissions
*I hereby authorize the House at Pooh Corner family daycare consent for any and all necassary emergency medical and first aidcare for my child/children while my child is in their care.
-Select a choice-
please choose
yes
no
*Do you consent to give House at Pooh Corner Staff permission to take photos/videos of my child/children for the House at Pooh Corner website.
-Select a choice-
please choose
yes
no
Please give us any other useful information that would assist in the care of your child/children
*Date of Application
*By typing my name as my signature, I am stating that I agree to the terms above
Welcome
Sign In
or
Register
Recent Photos