Child Enrollment & Emergency Medical Form

 

Mother
Father
Child 1
Example: David or דוד
Weekly Care Schedule
Please include the child's hours in care for each day. Our hours of care are from 7:30 AM to 6:00 PM.
Permission to Remove Info
Persons permitted to remove the child from the child care program on behalf of parent.
Emergency Contact Info
Please list two emergency contacts should we not be able to reach you directly
Medical Information
Child 2
Example: David or דוד
Weekly Care Schedule
Please include the child's hours in care for each day. Our hours of care are from 7:30 AM to 6:00 PM.
Permission to Remove Info
Persons permitted to remove the child from the child care program on behalf of parent.
Emergency Contact Info
Please list two emergency contacts should we not be able to reach you directly
Medical Information
Child 3
Example: David or דוד
Weekly Care Schedule
Please include the child's hours in care for each day. Our hours of care are from 7:30 AM to 6:00 PM.
Permission to Remove Info
Persons permitted to remove the child from the child care program on behalf of parent.
Emergency Contact Info
Please list two emergency contacts should we not be able to reach you directly
Medical Information

Emergency Authorization


Behavior Management and Parent Handbook