• Current Child's Information
  • Authorized Adults for Pick-Up
  • Questions/Comments
  • Waiver Form
  • Complete
Indicates required field

Child's Information

Please fill out this form for each of your children registered for any of the following programs at the Y:

  • Before School Care
  • After School Care
  • School's Out Club (full day care at the Y)


This information will be provided to the Y staff who are supervising your child at the school or at the Y.


Child's Information
This child is registered for:
Promotional Agreement
The Two Rivers YMCA and its funding partners have my permission to use photographs or videos of my child in YMCA promotional materials.
Internet Usage
I give permission for my child to use the internet under the supervision of the Y staff.
Flotation Device
My child needs a flotation device when swimming at the Y.
Sunscreen Application
I give permission to Y staff to help apply sunscreen on my child. I understand they will not apply sunscreen to any part of the body a swimsuit covers.