Parent and Emergency Contact Form
Thank you for registering online for a childcare program at the Y! Please complete the Parent and Emergency Contact form linked below and email it to firstname.lastname@example.org or bring your completed form to the Member Information Center at the Y. Your registration will not be complete until this form is received.
To use the fillable PDF registration form, please save the form to your desktop and open with Adobe Reader or Acrobat. Using the interactive form features in your browser window instead of Adobe Reader or Adobe Acrobat may prohibit file save or print.