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Enrollement Packets

This document provides information for registering a child at The Best Day Explorers childcare center. It requests details about the child, parents/guardians, emergency contacts, and payment information. It also provides policies on illness, medication administration, and emergency procedures. Children can be registered for programs named after famous explorers ranging from 6 weeks to 6 years old. Health details, permission for photos and sunscreen, and any additional comments are also requested.

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57 views3 pages

Enrollement Packets

This document provides information for registering a child at The Best Day Explorers childcare center. It requests details about the child, parents/guardians, emergency contacts, and payment information. It also provides policies on illness, medication administration, and emergency procedures. Children can be registered for programs named after famous explorers ranging from 6 weeks to 6 years old. Health details, permission for photos and sunscreen, and any additional comments are also requested.

Uploaded by

api-404143677
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Applying For:

__ Christopher Columbus (6 weeks- 12 months)


__Lewis & Clark (12 months- 24 months)
__Magellan (2 years olds)
__ Marco Polo (3 year olds)
__ Neil Armstrong (4 year olds)
__ Daniel Boone (5 year olds)
__ Sacagawea (6 year olds)

Parent/Guardian Information Registration Date:

Mother/Guardian First Name: M.I. Last Name:


Address:
Occupation: Home Phone: ( )
Employed By: Office Phone: ( )
Work Address: Work Hours: Cell Phone: ( )
[ ] Custodial Parent (If married, mark both parents) Mother’s SS#:
Email: Driver’s License #:
Preferred PIN number for checking in/out (4 digits, numbers only) 1st choice __ __ __ __ 2nd Choice __ __ __ __
Marital Status:[ ] Married [ ] Single [ ] Divorced [ ] Separated [ ] Widowed [ ] Other_____________________

Father/Guardian First Name: M.I. Last Name:


Address:
Occupation: Home Phone: ( )
Employed By: Office Phone: ( )
Work Address: Work Hours: Cell Phone: ( )
[ ] Custodial Parent (If married, mark both parents) Father’s SS#:
Email: Driver’s License #:
Preferred PIN number for checking in/out (4 digits, numbers only) 1st choice __ __ __ __ 2nd Choice __ __ __ __
Marital Status:[ ] Married [ ] Single [ ] Divorced [ ] Separated [ ] Widowed [ ] Other_____________________

Child Information
First Name: M.I. Last Name:
Name child prefers to be called: Grade/Class:
Child’s Address:
Gender: [ ] Male [ ] Female Date of Birth: Child’s S.S. #:
List any existing medical conditions, medication and/or special attention your child may require?

Allergies:
Pediatrician’s Name: Phone: ( )
Address:

Photographs: May we take and maintain a photo of your child for security purposes? [ ] Yes [ ] No

Emergency Contacts & Authorized Pickup Persons:

1st Contact/Pick Up Name: ___________________________________________ Phone: _________________


Relationship to the Child: __________________________PIN for check in/out (4 digits, numbers only) __ __ __ __

2nd Contact/Pick Up Name: __________________________________________ Phone: _________________


Relationship to the Child: __________________________PIN for check in/out (4 digits, numbers only) __ __ __ __

Tuition / Payment Information:


Current Tuition Amount: [ ] Weekly [ ] Bi-Weekly [ ] Monthly [ ] Other

Please outline below whom is responsible for payment of tuition and fees. Please fill out if parents are divorced and
split tuition payment or if tuition payment is the responsibility of an adult other than the parents listed above.

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Health Information
Physician’s Name:_____________________________ Phone:______________________

Physician’s Address:________________________________________________________

Allergies/Medical Conditions:_______________________________________________

Dentist:_______________________________________ Phone:______________________

Permission To Administer Sunscreen


Please select one option from the following!

I, _______________________________ give my childcare provider permission to apply childcare provided


sunscreen to my child before going outside for recess on any sunny days.

I, _______________________________ give my childcare provider permission to apply parent provided sunscreen


to my child before going outside for recess on any sunny days.

I, _______________________________ will be applying sunscreen to my child before school on any sunny days so
that application is not needed at school.

Additional Comments & Information:


Is there is any other information that that would be helpful to our management and teaching staff?

_____________________________________________________________________________________________

_____________________________________________________________________________________________
Signature:
Parent’s Signature: Date:

Thank You!
Illness and Medication:
Your child’s health is very important to us. A child who is ill is not functioning at their
optimum level and requires the constant attention of an adult. Since our staffing level does not
permit our Center to give constant one-on-one attention and we do not want to expose other
children to your child’s illness, please do not bring a sick child to the Center.
Children should be kept out at home until they have been symptom-free for twenty-four hours.
The child will be discharged should the following be detected:
- Vomiting
- Diarrhea
- Temperature of 101 degrees Fahrenheit.
- Conjunctivitis (pinkeye)
- Evidence of lice, scabies, or other parasitic infections
If a child exhibits any of the following signs or symptoms of illness, the teacher, along with the
director of the program will contact the parent:
- Severe coughing
- Difficult or rapid breathing
- Yellowing skin or eyes
- Sore throat or difficulty swallowing
- Complaints of earache, stomachache, or other pain
When a child has had a communicable disease, we ask that you notify the Center
immediately. Written notification from the child’s doctor is required for the child to return to the
Center after the child has had a communicable disease.
Medication WILL NOT be given unless the form is dated, indicates dosage, time to be
administered, and is signed by the parent. Over the counter medication that does not indicate
specific dosage for the child’s age and weight, must be accompanied by a note from the child’s
physician.

Emergency
A first aid kit is kept at The Best Day Explorers at all times. A staff person is always on
duty that is trained in Pediatric First Aid. In the event of an emergency, parents will be contacted
immediately. If we feel it is necessary, we will contact the Emergency Medical Service to assist
us in first aid and transport the child to the nearest hospital, as they see necessary. Should the
child be transported, a member of the Center’s staff will accompany the child. It is very
important to keep your emergency medical information up to date, as this is where we will get
our information.
The Best Day Explorers is required by law to immediately notify the local children’s protection
agency if there is a suspicion of child abuse or neglect.
Emergency drills are practiced on the following schedule. Fire drills are performed monthly and
inclement weather/disaster drills are performed on a quarterly basis.

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