

Child Care Forms
Here you will find access to all of the forms required by our child care programs. The YMCA has always focused on meeting the social, emotional and academic needs of our young learners so they can grow into the changemakers of tomorrow—and today is no different.
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The Y’s child care and out-of-school time offerings are staffed with people who understand the cognitive, physical and social development of kids, the support parents and families need and the importance of maintaining a safe, clean environment for children to learn and thrive. At the Y, infants develop trust and security, preschoolers experience early literacy and learn about their world and school-age kids make friends, learn new skills and get help with their schoolwork. Learn more about the Y’s offerings below.
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If you have any questions about these forms, please contact our program director Linsy Carson at lcarson@pikecountyymca.org
Enrollment Packets:
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Forms:
ODJFS 01305: CHILD MEDICAL STATEMENT FOR CHILD CARE
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ODJFS 01234: CHILD ENROLLMENT AND HEALTH INFORMATION FOR CHILD CARE
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ODJFS 01236: CHILD MEDICAL/PHYSICAL CARE PLAN FOR CHILD CARE
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ODJFS 01217: REQUEST FOR ADMINISTRATION OF MEDICATION FOR CHILD CARE
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