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Child Care Request Form


If you would like to receive child care for your meeting or event at Clover Lane or Market Street, simply complete the form below. Please be sure to include any extra information in the comments section, if needed. Please submit your request at least TWO WEEKS in advance.Your request will generally be processed within one to three (1-3) business days. You WILL receive an email once your request has been received.

NOTE: Once you click on Submit, please wait to ensure your request has been sent as you will see a page that tells you it has been completed. If you don't see this message, please submit your request again.

Please Note: All fields are required unless otherwise indicated.

Name:


Email:


Phone:


Group/Event Name:


Date Requested:


Start Time:


End Time:


Number of Children Expected (if known):


Location:


Room Assigned (Have you filled out a room reservation request? If so, what room has been assigned for your use):


Comments (Optional):








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