Application for Child Care [Note 1] hoge fuga moga hoge fuga moga [Note 2] hoge fuga moga hoge fuga moga [Note 3] hoge fuga moga hoge fuga moga Your Name* Your Email* Your Affiliation* Child's Full Name* Child's Gender* BoyGirl Child's Age* (If less than 1 year old, please specify in months) Does your child have any allergies?* YesNo Please specify the allergies: Preferred Dates and Times of Use* I have confirmed what I filled in.