Playgroup Child Attendance Form
Please complete this form to record your child's attendance and provide essential contact and health information for the playgroup.
Child's Full Name
*
First Name
Last Name
Date of Attendance
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Child's Age
*
Group/Class Name
*
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Emergency Contact Name
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Who is authorized to pick up the child? (List all names)
*
Drop-off Time
*
Hour Minutes
AM
PM
AM/PM Option
Pick-up Time
*
Hour Minutes
AM
PM
AM/PM Option
Does your child have any allergies or medical conditions? Please specify.
Parent/Guardian Signature
*
Submit Attendance
Submit Attendance
Should be Empty: