Application for Child Care Services

Application for Child Care Services
At which location are you enrolling?*
Enrollment Date:*

MonthDayYear
Date
Childs Full Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
Date
Gender*
Siblings names & ages*
Primary Responsible Party
Name of primary responsible party*
Relationship to child*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number*
Please enter a valid phone number.
Work Phone Number*
Please enter a valid phone number.
Cell Phone Number*
Please enter a valid phone number.
Cellphone Carrier*
Responsible Party Employer Name / Location*
Job Title*
Email*
example@example.com
Responsible Party Social Security Number*
Responsible Party Date of Birth *

MonthDayYear
Date
Second Responsible Party
Name of second responsible party
Relationship to child
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Cellphone Carrier
Second Responsible Party Employer Name / Location
Job Title
Email
example@example.com
Second Responsible Party Social Security Number
Second Responsible Party Date of Birth

MonthDayYear
Date
Our program does not exclude children with special needs, for us to provide a safe environment, the following information is required:
Previous Child Care Experience*
Special Needs of Parent (inability to climb stairs, difficulty lifting child etc.)*
Special Needs of Child or Conditions Requiring Special Considerations (medications, treatments, or allergies)*
Food Child Likes*
Elimination Patterns (toileting/diapering)*
Things That Comfort Child*
Things That Scare Child*
Cultural Habits/Home Issues That May Affect Child’s Behavior*
Who Will Care for the Child When They Are Ill and Unable to Attend School*
Is there a court order effecting custody of your child? If yes, responsible party must provide Future Generation a certified copy of the court order (with the raised seal) before child can attend Future Generation.*

YesNo
Allergy Action Plan Document

Cancelof
Asthma Action Plan Document

Cancelof
Medical Treatment Plan

Cancelof
Authorization for Emergency Care
I authorize my child to be taken to the nearest hospital for emergency medical care. I will assume full financial responsibility for services rendered by the hospital and/or transport services.*
Name of Insurance Company:*
Name of Policy Holder:*
Group Number:*
Physician’s Name*
Phone Number*
Please enter a valid phone number.
Pediatric Dentist Name*
Phone Number*
Please enter a valid phone number.
Responsible Party Signature*

Clear
Date*

MonthDayYear
Date
Responsible Party Signature*

Clear
Date*

MonthDayYear
Date
Transportation Plan
(name of child)will be dropped off at Future Generation by blank will be picked-up in the afternoon by Type a label
Parent Signature*

Clear
Date*

MonthDayYear
Date

Future Generation Parent Code of Conduct
At Future Generation, respect is a core value that is woven into our philosophy and taught to children every day. As part of our school community, it is essential that all parents and guardians understand and adhere to the following expectations outlined in our Parent Code of Conduct.

By enrolling my child at Future Generation, I agree to the following:
- I will not use profanity, physical violence, threatening gestures, or inappropriate tones with any child, adult, or employee while on Future Generation property or at school-sponsored events.
- I will remain in control of my actions and behavior at all times.
- I will respect confidentiality, understanding that protecting the privacy of both children and adults is essential to maintaining a positive and professional environment. Breaches of confidentiality can cause significant harm to reputations and relationships.
- If I have a concern, question, or complaint, I will address it through the appropriate channels by completing a Parent/Educator Communication Form and following the center’s communication procedures.
- While I reserve the right to discipline my own child, I understand that I may never discipline or reprimand other children at any time.
- I will refrain from using physical discipline with my child while on Future Generation property or during off-site field trips and school events.
- I understand that the relationship between Future Generation employees and parents must remain professional at all times. Personal relationships, private arrangements, and fraternization outside of the school setting are not permitted. This includes contact through social media platforms. I will not “friend,” follow, or communicate with employees on social media.
- I acknowledge that the use or presence of nicotine, alcohol, marijuana, or other controlled substances is strictly prohibited on Future Generation grounds. I will ensure that my child does not arrive at the center smelling of any such substances.
I understand that failure to adhere to this Parent Code of Conduct may result in suspension or termination of my child’s enrollment at Future Generation.
Full Name*
Signature*

Clear
Date*

MonthDayYear
Date

Future Generation Early Learning Centers Expulsion Policy
At Future Generation, we take pride in our long-standing commitment to meeting the individual needs of every child in our care. We partner with families whose children may require additional support and, when appropriate, make referrals to outside specialists. These may include, but are not limited to, early intervention services, speech therapy, occupational therapy, physical therapy, and other support providers. Our team will also participate in Individualized Education Program (IEP) meetings as appropriate to help ensure the best outcomes for each child.

Future Generation makes reasonable accommodations to our policies, practices, and procedures in accordance with applicable federal and state laws. However, we are not required by law to make fundamental changes that would alter the nature of our program or services for a child exhibiting dangerous or severely disruptive behavior, developmental delays, or disabilities as defined by the Americans with Disabilities Act (ADA).

We welcome outside service providers and therapists into our program to support individual children when:
- The need for services is communicated to the center in advance.
- The provider holds the necessary clearances and background checks required to enter the building.
- The child’s behavioral or therapeutic plan is shared with the center’s administration.
- The provider works collaboratively with Future Generation staff and follows center guidelines.
- The provider’s presence helps mitigate safety risks presented by the child to themselves or others.
If an outside therapist or service provider becomes disruptive to the program or is unable to help reduce dangerous behaviors through appropriate therapeutic interventions, the child may be excluded from the program until a more effective support plan is in place.

Safety Considerations and Temporary Suspensions

Any child who poses a safety threat to themselves or others may be subject to suspension, exclusion, or disenrollment if the behavior cannot be mitigated through reasonable accommodations under applicable federal and state regulations. In certain cases, a temporary suspension (referred to as a "Reset Day") may be necessary to ensure the safety of all children and staff. This pause will provide time for necessary evaluations and the implementation of appropriate support services.

Parental Communication

Future Generation will provide written documentation to parents whenever a child is referred for outside support services due to behavior, developmental concerns, or a suspected disability. Through ongoing communication—including formal and informal conferences, incident/accident reports, and written correspondence—Future Generation will keep parents informed of:

The child’s behaviors that pose a danger to themselves or others.
The steps the center has taken to accommodate the child.
Notification if the child cannot return until appropriate support services are in place.

Causes for Immediate Expulsion
- Immediate expulsion from the program may occur in the following cases:
- The child presents an immediate risk of causing serious injury to themselves or others.
  A parent violates the center’s Parent Code of Conduct.
Causes That May Lead to Expulsion After a Suspension or Temporary Removal
- Uncontrollable tantrums or dangerous outbursts.
- Ongoing physical or verbal abuse of employees or other children.
- Excessive biting.
Protection Against Retaliatory Expulsion

A child will not be expelled from the program for the following reasons:
- The parent has made a complaint to the licensing agency.
- The parent has reported suspected abuse or neglect occurring at the center.
Parent Full Name*
Signature*

Clear
Date*

MonthDayYear
Date

Future Generation Parent App Information Collection Form

Future Generation uses a daily parent communication software. Please fill out the information below so we can assure that your contact information is entered into our system correctly. It is your responsibility to provide the center with photographs of all parties who are authorized to remove your child from our school. Please email them to the Director.
Child's Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Classroom*
Child's schedule*
Primary Individuals Full Name*

First NameLast Name
Email*
example@example.com
Cell Phone Number*
Please enter a valid phone number.
Work Phone Number*
Please enter a valid phone number.
Primary Individuals Full Name*

First NameLast Name
Email*
example@example.com
Cell Phone Number*
Please enter a valid phone number.
Work Phone Number*
Please enter a valid phone number.
Please List Names and Phone Numbers of People Authorized to Pick Up Your Child from Future Generation:

Please email pictures of your authorized pick-ups to your Center Director.
Authorized Person 1*
Authorized Person's Phone Number*
Please enter a valid phone number.
Authorized Person 2*
Authorized Phone's Phone Number*
Please enter a valid phone number.
Authorized Person 3
Authorized Person's Phone Number
Please enter a valid phone number.
Authorized Person 4
Authorized Person's Phone Number
Please enter a valid phone number.

Future Generation Social Media Policy

Please read, sign, and date the following guidelines outlining Future Generation’s use of social media in the classroom and as a marketing tool.
At Future Generation, we use social media as a tool to celebrate our school community and to share highlights of our program with current and prospective families.

By signing below, I acknowledge and agree to the following:
- I understand that Future Generation may post photographs of my child on its official social media sites for marketing and promotional purposes.
- I understand that my child’s photograph may also appear on other parents’ personal social networking sites if taken during classroom events where parents are present as third-party participants.
- I acknowledge that the center’s primary means of mass communication is through the Parent Communication App.
- Currently, Future Generation uses the following platforms for marketing: Facebook, Instagram, and our official website at www.fgkids.org.
- Future Generation’s social media accounts are set so that parents may “like” posts and share them with friends. Commenting on posts is not permitted to maintain a safe and positive online environment.
- As outlined in the Parent Code of Conduct, parents are not permitted to be "friends" with Future Generation employees on any form of social media. Maintaining a professional boundary between parents and employees is essential to the integrity of our school environment.
We appreciate and value your support in respecting all Future Generation policies and procedures.

By signing below, I acknowledge that I have read, understand, and agree to abide by the terms of this Social Media Policy. I understand that failure to comply may result in consequences regarding my child’s continued enrollment.
Parents Full Name*

First NameLast Name
Signature*

Clear
Date*

MonthDayYear
Date

Future Generation Permission to Screen
Throughout the school year, Future Generation Early Learning Centers partners with local community resources, including the Health Department and resource and referral agencies, to provide on-site screenings that support the health and development of young children.

With your permission, the following free services (when available) may be offered at the center:

Hearing Screening

Dental Screening

Vision Screening

Social Emotional Development Screening

These services are designed to help identify any potential concerns early, allowing parents to seek follow-up care or support as needed.

By signing below, I give permission for my child to participate in the above screenings conducted at Future Generation Early Learning Centers.
Permission Choice:*

I give Future Generation Early Learning Centers permission to evaluate and screen my child.I do not give Future Generation Early Learning Centers permission to evaluate and screen my child.
Child's Full Name*

First NameLast Name
Responsible Party Name*

First NameLast Name
Responsible Party Signature*

Clear
Date*

MonthDayYear
Date

Future Generation Food Policy
Please be advised that the following are guidelines that need to be followed when providing food to the children in childcare in the state of New Jersey. Please ensure that the food you are sending from home MEETS the guidelines.
- No sugar sweetened or artificially sweetened beverages shall be served.
- No solid food shall be provided to children under the age of 6 months.
- No cow's milk shall be provided to children under the age of 12 months.
- Whole milk is provided to children ages 12-24 months.
- Reduced fat milk is provided to children over the age of two.
- Foods that are high in solid fats, added sugars, trans fat and sodium shall be limited. *
- Foods left uneaten in a dish will be discarded.
- Unused, not served food must be discarded if not consumed within 24 hours.
- Food choices from home are encouraged to include healthy options (i.e. fruit, meat, grains, and vegetables).
- Chips and candy are prohibited as daily snacks.
- Infants are encouraged to use spoons and fingers to feed themselves.
- Glass containers and bottles are prohibited in the center.
- Children are encouraged to drink from a cup starting at 6 months. *
- Bottles will not be prepared with anything other than formula or breast milk in them.
I have read the Future Generation Food Policy and agree to abide by the guidelines.
Parent's Name*

First NameLast Name
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Application for Child Care Services

Primary Responsible Party

Second Responsible Party

Authorization for Emergency Care

Transportation Plan

Future Generation Parent Code of Conduct

Future Generation Early Learning Centers Expulsion Policy

Future Generation Parent App Information Collection Form

Future Generation Social Media Policy

Future Generation Permission to Screen

Future Generation Food Policy