Shabbat Morning Babysitting

Date Attending

October 5October 12October 19October 26

Child's Name

Home Phone Number

Age of Child

E-Mail

Can your child use the restroom without assistance?

Does your child have allergies?

Yes

If your child has allergies, please explain and let us know whether they use an epi-pen

If you give permission for the babysitting staff to assist with restroom needs, please provide your initials

I give permission for the babysitting staff to assist my child with restroom needs

YesNo please alert me so I can assist them myself.My child does not require assistance

If your child requires assistance with the restroom, please bring diapers and wipes for babysitters

Tue, October 15 2024
13 Tishrei 5785

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Tue, October 15 2024 13 Tishrei 5785