Itty Bitty City - Drop-in Child Care - Katy, Texas

Register your kids for the City!

Mom's Info
     
First Name:
Last Name:
Work Phone:
Cell Phone:
Driver's License:
 
 
 
Dad's Info
  
 
First Name:
Last Name:
Work Phone:
Cell Phone:
Driver's License:
    
     
Home Phone Number:
   
Primary Email Address:
   
Mailing Address:
Emergency Contact
 
Name:
Phone Number:
 
Secondary Releases: My Child(ren) May Be Released to:
(Other than parents)
 
 
I give my consent for emergency medical treatment
 
In the event I cannot be reached to make arrangements for emergency medical attention I authorize the Itty Bitty City staff to have my child(ren) taken to:
   
(St. Christus, Katy Memorial, etc.)
Physician Name:
Physician Address:
Physician Phone:
 
I acknowledge receipt of Itty Bitty City's Operational Procedures. I have read, fully understand, and agree to abide by these Operational procedures
   
Who can we thank for your referral:
 

 Hourly Child Care    22052 Westhiemer Parkway. Katy, TX 77450    Phone: (281) 829-2388    Fax: (281) 829-3068