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CHILD CARE ENROLLMENT FORM (For Neurotypical Children) Inclusive Child-Minding & Day Care Center Child Care Enrollment Form

The document is a Child Care Enrollment Form for neurotypical children at an Inclusive Child-Minding & Day Care Center. It collects essential information about the child, parent/guardian, health details, childcare needs, and includes a consent and waiver section. The form is designed to ensure the center has all necessary information to provide appropriate care for the child.

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seth2bianosa
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40 views2 pages

CHILD CARE ENROLLMENT FORM (For Neurotypical Children) Inclusive Child-Minding & Day Care Center Child Care Enrollment Form

The document is a Child Care Enrollment Form for neurotypical children at an Inclusive Child-Minding & Day Care Center. It collects essential information about the child, parent/guardian, health details, childcare needs, and includes a consent and waiver section. The form is designed to ensure the center has all necessary information to provide appropriate care for the child.

Uploaded by

seth2bianosa
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

1.

CHILD CARE ENROLLMENT FORM (For Neurotypical Children)


Inclusive Child-Minding & Day Care Center
CHILD CARE ENROLLMENT FORM

A. CHILD’S INFORMATION
 Full Name of Child: ______________________________
 Nickname: ______________________________
 Date of Birth (MM/DD/YYYY): _____________________
 Age: _______ Gender: ☐ Male ☐ Female
 Home Address: _________________________________
 Birth Order (e.g., Eldest, Youngest): ________________

B. PARENT/GUARDIAN INFORMATION
 Parent/Guardian Name: __________________________
 Relationship to Child: ____________________________
 Contact Number: _______________________________
 Alternate Contact Person & Number: ________________

C. HEALTH INFORMATION
 Pediatrician’s Name: ____________________________
 Any known allergies: ☐ Yes ☐ No
If yes, specify: __________________________________
 Any medical conditions we should be aware of? ☐ Yes ☐ No
If yes, specify: __________________________________
D. CHILDCARE NEEDS & ROUTINE
 Usual Nap Time: _______________________________
 Feeding Instructions (if any): ______________________
 Special routines or habits: ________________________
 Triggers or situations that upset the child: ____________
 Comfort strategies that work: _____________________

E. CONSENT & WAIVER


I, the undersigned, understand and agree to the terms and policies of Inclusive
Child-Minding & Day Care Center. I consent to my child’s participation in all
center activities.
Parent/Guardian Name & Signature: ___________________________
Date: _______________

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