Parent’s Day Out – Registration Form

When: Saturday, December 5th

Time: 10 - 2

Who: 6 weeks old – 5th grade

Where:Baby Gator at Lake Alice

What’s included?

  • Supervision by Baby Gator Child Development and Research Centers staff and volunteers
  • Pizza Dinner
  • Arts and crafts, games, activities

Cost: $30 for the first child and then $15 for each additional child

This childcare event is limited to 30 children.

No walk-in registrations.

To reserve your child’s space

  • Complete the registration and emergency contact information below and return these forms and your check payable to the University Of Florida

By mailIn person

Nika LorenzNika Lorenz

Baby Gator Newell DriveBaby Gator at Newell Drive

PO Box 1000181244 Newell Drive

Gainesville FL 32610

You will receive an email notice when your child has been registered.

Register early—spaces are limited!

In order to cancel your reservation you need to do so by the Wednesday prior to the event.

REGISTRATION FORM

Parent(s) Name: ______

Please circle the dollar amount for each day you would like your child to attend.

Child’s name / Age / Saturday, December 5th
$30.00
$15.00
$15.00

Total Payment due: $ ______

Please make checks made payable to the University Of Florida

EMERGENCY CONTACT INFORMATION

Please complete a form for EACH child

Child’s Name______Child’s Age____ Child’s Grade______

How can parent be contacted between 5pm – 9pm?

  • Cell phone:______
  • Text:______
  • E-mail:______

If we cannot reach you in an emergency, who should we contact?

Name______Phone______

Does your child have allergies? YES NO

If YES, please explain how we can keep your child safe during this child care event.______

  • please note that we CANNOT provide a nut-free environment

Does your child have any food restrictions? YES NO

If YES, please explain what foods your child is not permitted to eat.______

  • a menu will be available the day before, limited substitutions will be available

Does your child have a medical condition that may need to be addressed during this child care event? YES NO

If YES please explain how we can keep your child safe during this child care event.______

I give permission for Baby Gator teachers to take my child listed above on walks around the University of Florida campus. YES NO

Parent Signature ______Date ______