If your child is being cared for by Little Beans during a wedding or event, please complete this form to enable us to offer them the best care.

Parent details

Name *

First

Last

Phone *

Child's Details

Name *

First

Last

Gender *

• Male
• Female

Date of birth

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Child's medical

Allergies, conditions, prescribed medicines, etc we needs to be aware of

Child's routine

An idea of your child's normal routine during the hours of childcare.

Specific care instructions

Any specific instructions regarding your child's care

Permissions

Collection *

We will not release child to anyone other than parents and those listed here.

Password *

Used to collect child

Photographs *

• Yes
• No

Used in marketing (with faces obscured) or sent to parents/event planner

Personal care *

• Yes
• No

Changing clothes, bath/wash, changing nappy, etc.

Health care *

• Yes
• No

Administer first aid, contact emergency services if necessary or administer medication with written consent.

Venue details

Venue address *

Address Line 1

City

State / Province / Region

Room number

Date of event *

Submit