Childcare Provider Access Request

A recent photo is required which can be taken at check-in.


To request one childcare provider access card for your family, please complete the following information. This access card may be used to gain access to The Village Club by the person accompanying your children only in the absence of the parents or guardians.


Name of the family making the request(required)

Childcare Provider:

Childcare Provider Policy:

  • Childcare Provider must remain with the children supervised.
  • Childcare Provider must submit a recent picture of herself at check-in
  • Childcare Provider pays the guest fee when at the club with the parent.
  • Childcare Provider does not have the privilege to bring in guests.
  • Childcare Provider entry to club is limited to their role or as a guest.
  • Childcare Provider is not covered by the club’s insurance carrier.
  • Childcare Provider must follow the club rules and club polices.

Failure to follow the Childcare Policy results in a warning and a $25 fine.
The second time the privilege for the provider and/or family is revoked.

Signatures required: