Register with Swiss Cheese

Family Intake Form

Thank you for inquiring with Swiss Cheese Childcare Collective. The following information will begin to get you registered with us and will only be used internally amongst the childcare providers. We look forward to providing you with great childcare. I will call you to discuss any questions you have and to complete the registration process.

Please fill in all required fields
.

Parent's Names

Your email

Address

City, Zip

Phone 1 (Best # regarding childcare, Please Specify)

Phone 2 (Please specify)

Emergency Contact (Name, relationship, & phone number in case parents are not available.)

What kind of childcare are you seeking? (Give us a general idea of what you are looking for. Date nights, 2 a month, vacation care...etc.)

Child 1 (Name and Dob)

Child 2 (Name and Dob)

Child 3 (Name and Dob)

Tell us about your children (e.g., allergies, ways to win them over, specific challenges

Tell us about your household, elders, pets, haunted, etc.

Would you be open to working with a male babysitter?

Would you be open to working with a mother who brings her child?

Is your home public transportable?

Describe any parking restrictions

How did you hear about Swiss Cheese Childcare?

Name If recommended by a friend

I accept. By checking the "I accept" box, you are agreeing to Swiss Cheese Childcare's Terms of Use as they are stated.

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