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child care request

Improv Care understands that professional training and developed child care skills are important ingredients for a successful care experience. We also know that properly matching the care provider with each child and family results in an exceptional experience.

We carefully compare the needs and interests of each child with the talents and personalities of our care providers. We will use your completed child care questionnaire to match the right care (or education) professional with your child or adolescent and develop their individualized (or group) activity plan.

Please fill out ONE child profile form for EACH child. All information is strictly confidential.

1. Parent name(s), first and last


2. Child's name(s)


3. Child's age

4. Child's date of birth

5. Email address


6. Event or Group name that you are registering your child for


7. Date(s) you require child care

8. Start to finish time

9. Please provide us with the name of the hotel you are staying at


10. Home address (please include street, city, prov/state, postal/zip code)


11. Cell phone number

12. Alternative number

13. Emergency contact person:
Name
Number

14. Allergies: type, high risk or low risk, treatment, please explain


15. Medical issues: please describe


16. Restrictions: diet, rest, exercise, mobility, off-limit activities


17. Meal arrangements: favourite meals and snacks, restricted foods


18. Regular or special routine requirements: car, booster seat, toys, swimming
Please explain


19. Child/teen’s favourite activities: books, songs, toys, games


20. Comforting your child: your secrets (ways to be held, silly things for a laugh etc.)


21. Please share any additional information that you would like us to know about your child or family


22. How did you hear about our service?


We will call you within 48 hours of having received your child care request.




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