Great Commission Conference Childcare Form Please note that this form must be filled out for each child you intend to enroll.Basic InformationChild's Name* First Last Age*Infant1234567Potty Trained*YesNoGrade in School*Parent/Guardian InformationParent/Guardian 1* First Last Parent/Guardian 1 Phone*Parent/Guardian 1 Email* Parent/Guardian 2* First Last Parent/Guardian 2 Phone*Care InstructionsAllergies or Special Medical Concerns*Bottle Times & AmountsOther Feeding Instructions(cereal, baby food, etc.)Nap TimesMedicationsPlease include the name, amount, time to be given, and time last given.Other Special InstructionsChild Pick-up AuthorizationThe following individuals are authorized to pick up this child in addition to the Parents/Guardians listed above. (MUST HAVE ID BRACELET) An ID bracelet will be given to you when you drop off your child.Person 1 First Last Person 1 Relationship to Child/ParentsPerson 2 First Last Person 2 Relationship to Child/ParentsPerson 3 First Last Person 3 Relationship to Child/ParentsConfirmationIs it ok if we take pictures of your child?*YesNoBy submitting this form, you are confirming that all information supplied is true and accurate.*YesNoElectronic Signature (Enter your full name)*