Returning Reservation Request

Please use this form for reservation requests that are at least 24 business hours in advance. If your need is urgent, please TEXT YOUR REQUEST TO (608) 719-4024!!!

Parent's Name(required)

Email(required)

Phone(required)

Child(ren)'s Name--PLEASE LIST EACH CHILD INDIVIDUALLY(required)

Date of Reservation Requested(required)

Time of Reservation Requested (Begin AND End)(required)

Will you be using outside funding for this reservation (Ex. Kids Kare, Shares, SMPH DISCOUNT)?

Do you have a UW Madison affiliation? Note: This is not a requirement to use the centers.(required)

If you have a UW Madison affiliation, please enter your department below. ASK ABOUT OUR SCHOOL OF MEDICINE AND PUBLIC HEALTH DISCOUNT!

I have read and understand Little Chicks policy and procedures

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