This form provides us with emergency contact information, it tells us who aside from the parents are allowed to pick up the child.
Please note: Each field must be completed. Please use N/A as needed.
This form gives us the information needed to register you and your child into our billing system. You only need to complete one form for the entire family.
This form must be completed by a health care professional within 30 days of enrollment. If your child is school age they will only need a new actual physical if they are entering kindergarten or 6th grade. Please include a copy of the immunization records.
This form is to tell us how you would like to be billed. All fees are due the Friday prior to the week of care. Payments can only be made by direct payment on either Checking Account or Credit Card.
This form is about the safety and protection of your child. Please read thoroughly and sign.
Please read our code of conduct thoroghly and sign. To view the complete childcare handbook, please click here.
The Butler YMCA is a non-profit, charitable organization open to all people, regardless of age, sex, race, religion, ability or income. Our mission is to put Christian principles into practice through programs that build healthy spirit, mind and body for all.