Register for Childcare

* Required

    11th annual Queer Women of Color Film Festival

    Please fill out this form completely to register your child for Child Care. If there are any blank sections, you will need to complete them when you check-in. This information is necessary so that we can provide a great Child Care experience.

    Child Care Shifts

    Which event will you attend? Please indicate which screening(s) you will attend. PLEASE NOTE that if you attend more than 1 (one) event, you will need to provide enough food and snacks for your child while they are in Child Care.
    This is a required question
    This is a required question
    This is a required question

    PARENT OR GUARDIAN INFORMATION

    When you check into childcare, we will also make a note of the location of your seat(s) in case we need to contact for some reason during the screening.
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Child Information

    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Personality & Family

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Health

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Emergency Contact Information

    Other than Parent/Guardian
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    PLEASE BE AWARE

    We will ONLY feed your child food that you provide, including snacks. We want to prevent allergic reactions. We want to ensure that they have the foods and portions that you want them to have. Please make sure that your child is fed before bringing them to childcare and/or provide food & snacks for them. We will NOT administer medication to your child. If your child requires medication, you or someone you authorize will have to administer any medication.
    This is a required question

    Questions?

    Email festival@qwocmap.org or call 415-752-0868, we’ll be happy to answer you!

    Please submit this application form by Thursday, June 12

    If you submit before the deadline, you will help us greatly to accommodate your child and your childcare needs.
    Never submit passwords through Google Forms.
    100%: You made it.