Childcare Request Form

Name

First Name

Last Name

Phone

(###)

###

####

Email Address

Children

Please list each child's name & date of birth on a separate line below.

Food Allergies

List any food or medical allergies.

Caretaker Preference

On occasion, young adults ages 16 or 17 serve as child caretakers during C3 events. We respect that this might not meet the needs of your child or your parental preference and we wish to honor this. While all caretakers under age 18 have been vetted and specifically selected for their experience, capability, and character, those 18 and over have additionally passed federal and local background checks. Please let us know your preference below so we can schedule to best serve your family.

Event Name

List event name. (Example: ML Meeting, Worship Team Practice, FPU, etc.)

Event Date

YYYY