Childcare Interest Form

CHILDCARE APPLICATION DUE DATE - EXTENDED TO JULY 7TH

IM4US is connecting parents to a drop-in childcare center called Near the Pier Child Development Center* for the IM4US 7th Annual Conference. The facility is a 10-minute walk from both conference venues. Please click each link below to see walking directions between the conference venues and Near the Pier:

Walking distance from Prentice Women's Hospital for Thursday's Preconference

Walking distance from Feinberg Pavilion for Friday & Saturday's main conference. 

Please read the details below before submitting the Childcare Interest Form:

  1. Near the Pier charges $90 per child per day for all-day drop in care. If this is a hardship, please indicate on the application below.
  2. Near the Pier can supervise children from 6 weeks to 12 years of age. 
  3. Breakfast and lunch will be provided on Thursday and Friday. Parent must supply breast milk or formula, if applicable.
  4. Breakfast only will be provided on Saturday. Parent must provide child's lunch. 
  5. Drop-in childcare hours are Thursday & Friday, 6:30 am to 6:30 pm and Saturday, 8:00 am to 6:30 pm.
  6. Parents will be required to fill out an ENROLLMENT PACKET as required by Near the Pier. 
  7. Parents will need to read the PARENT HANDBOOK prior to filling out the enrollment packet.

If the details provided above are suitable to your needs, please fill out the interest form below. 

* Disclaimer: The childcare program IM4US has arranged with Near the Pier is not an endorsement. Parents must use their own discretion when placing their children in the care of this or any childcare provider. 

Thank you!

Parent First Name*
Parent Last Name*
Parent Email*
How many children would you like to enroll?*
Names and age(s) of the child(ren) you'd like to enroll*
Drop In Childcare Hours
Near the Pier will offer childcare on the following schedule:

- Thursday & Friday: 6:30 am to 6:30 pm
- Saturday: 8:00 am to 6:30 pm

Which days do you need childcare?*



Childcare Fees
Near the Pier charges $90 PER CHILD, PER DAY for drop in childcare. We may be able to provide assistance, but our funds are limited and priority will be given to those with the highest need.

Please select "yes" below if you are requesting financial support.

Are you requesting financial assistance to cover some or all childcare fees?*