2019 Annual Conference CHILDCARE registration

The Contact information above MUST be the child's parent or guardian.

Our Child Care Program is operated on a first come, first serve basis. We have a limited amount of space available for the program (12 children).
The cost of child care is $25 per child.

Childcare will be available during the following days/times:

  • Wednesday June 5: 12:30 pm - 5:00 pm, 6:45 pm - 9:00 pm.
  • Thursday, Friday:  7:45 am - 5:00 pm, 6:45 pm - 9:00 pm
  • Saturday: 7:45am - 6:45pm (dinner NOT provided)
1 - Child Personal Information
Name of Parent/Guardian
First Name
Last Name
Email
Name of Child(ren)
*First Name *Last Name
2 - Parent/Guardian Information
*Street Address

This field is required.

*City/State/Zip

This field is required.

*Phone Number

This field is required

3 - Church and District Information
*Lay Church Membership / Clergy Appointment

A selection is required.  Clergy, if you are appointed to a multi-point charge, select any one of the churches.

*District

A selection is required

4 - Registration Information
*Childcare is a program for Children who are 6 or under during Annual Conference.
  • If you are registering more than 1 child - You must select a separate answer for each child.
  • The cost of child care is $25/child.
  • If you are wanting to register a child who is older than 6, please go back and use the RECESS registration form. 
Register my Child for Childcare - You MUST select the required days below ($25)
*Select the days that you require Child care

If you are registering more than 1 child - You must select a separate answer for each child. The cost of Childcare is $25 per child.

Wednesday
Thursday
Friday
Saturday
*Identify the Age of your child

This selection is required.
If you are registering more than 1 child - You must select a separate answer for each child.

less than 1 year old
1 year old
2 years old
3 years old
4 years old
5 years old
6 years old
Reminder to Parent/Guardians

You MUST pick up your children before the evening meal as soon as possible after the close of the afternoon plenary session.
This is necessary so that our childcare providers are able to have some down time.

5 - Emergency Contact Information - REQUIRED

For emergency contact information, if you are registering more than one child, you do NOT need to enter separate information for each child.

*Emergency Contact at Annual Conference - Name

This is a required entry. Enter the full name of your child's emergency contact at Annual Conference.
This is somebody who will be at Grove City during the same time as your child.

*Emergency Contact at Annual Conference - Cell Phone Number

This is a required entry. Enter the cell phone number of your child's emergency contact at Annual Conference.
This is somebody who will be at Grove City during the same time as your child.

*Emergency Contact at Home - Name

This is a required entry. Enter the full name of your child's emergency contact at home.
This is somebody who will NOT be at Grove City during the same time as you.

*Emergency Contact at Home - Phone

This is a required entry. Enter the home and/or cell phone numbers of your child's emergency contact at home.
This is somebody who will NOT be at Grove City during the same time as you.

6 - Child Medical Information

If you are registering more than 1 child - You must select a separate answer for each child.

*Allergies

This is a required field. Please enter any allergies in the box below. If none please enter "none"

*Medical Conditions

This is a required selection. Select all that apply. If none apply to your child, please select "none of these conditions apply"

Insulin Dependent Diabetes
Heart Disease
High Blood Pressure
Seizure Disorder
Asthma
Rescue Inhaler
None of these conditions apply
*Medications

This is a required entry. List all of your child's current medications. If none, enter "none"

*Current Health Issues that may need to be addressed at conference

This is a required entry. If none please enter "none"

7 - Refund and Cancellation Policy
*WPAUMC Refund and Cancellation Policy

Click Here to view the Refund and Cancellation Policy.

Yes, I have AGREE with the WPAUMC Refund and Cancellations Policy
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