BCDC Enrollment Form
  • Enrollment Form

  • Child's Information

  • Format: (000) 000-0000.
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  • Parent/Guardian 1 Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

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  • Parent/Guardian 2 Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

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  • Authorized Child Pickup and Emergency Contacts

    Please list those individuals other than the parents/guardians listed above that are authorized to pickup your child. The persons listed below are also used as emergency contacts in the event that you cannot be reached. At least one individual listed must have an address that is not the same as the parent/guardian listed above and all listed individuals must be at least 18 years of age.
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  • Authorization for Emergency Medical Attention

    In the event I cannot be reached to make arrangements for emergency medical care, I authorize the person in charge to take my child to:
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  • I give consent for the facility to secure any and all necessary emergency medical care for my child.

  • Clear
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  • Attendance

    My child will normally be in attendance the follow days and times:
  • School Age Children

  • My child’s immunization records, vision, and hearing screenings are on file at the school listed below and are current.

  • Clear
  • Special Needs

    List any special problems that your child may have, such as allergies, food allergies (diagnosed by a doctor and require medical treatment if exposed), food intolerances (items that irritate but do not require medical treatment), existing illness, previous serious illness, injuries and hospitalizations during that past 12 months, and medication prescribed for long-term continuous use, and any other information which caregiver’s should be aware of:
  • Permissions

  • Clear
  • Photo Release

  • Clear
  • Agreements

  • Parent Handbook

    I acknowledge receipt of the facility’s operational policies (parent handbook) including those for discipline and guidance.  

  • Clear
  • Meals

    I understand that breakfast, lunch, and afternoon snack will be provided and served to my child when they are in attendance; our after school program is also served a supper when they arrive from school.I also understand that outside food/drink is not permitted past the front lobby, exceptions are only allowed on special party days when the food is dropped off in the kitchen and then distributed to the classrooms.

  • Clear
  • Outside Employment

    I understand that the staff members at this facility are prohibited in participating in outside employment with parents, this includes but in not limited to babysitting.

  • Clear
  • Social Networking

    I understand that the staff members at this facility are prohibited in participating in social networking activities with parents and children enrolled at the facility. (Such as Facebook, Instagram, Snapchat, Pinterest and Twitter)

  • Clear
  • I acknowledge receipt of the facilities written copy of the Provider's Guild To Parents Rights.

  • Clear
  • Parent Orientation Plan – Checklist

  • Welcome! This is your orientation checklist. We have already shared the majority of this information with you on your tour of our center.  We we are also providing you with a copy of the center’s Parent Handbook which contains information on all of these topics. This orientation is intended to help you understand what you need to know as you leave your child in our care. We plan to cover all areas listed below with you. If an area is not covered or if you do not receive a copy of the Parent Handbook, please be sure to let us know.

    • Tour of the facilities
    • Check in/out procedures
    • QR code Check In/Out system
    • Overview of CCMS (if applicable)
    • Discontinue use of technology when picking up your child (no cell phone zone)
    • Introduction to teaching staff
    • Classroom Visit
    • Overview of Parent Handbook
    • Policy for arrival & late arrival
    • Texas Rising Star Quality Certification
    • Late pick-up fees
    • Community support resources
    • Community Activities
    • Developmental milestones
    • Consistent arrival time
    • Procare Engagement App
    • Release of children to authorized person
    • Open Door Policy
    • Illness and Injury
    • Confidentiality
    • Medication
    • Tuition
    • Fees for late payment
    • Late pick-up fees
    • Additional fees (field trips, activities, supply fees, etc)
    • Alcohol and drug policy
    • Non-smoking policy
    • Expectations of the family
    • Needs of the child
  • Parent Support of the Program
    Children feel most comfortable here when they know that their parent is invested in the center in some way. In addition to enhancing the quality of the program, parent involvement increases children’s sense of security. Parents are encouraged to spend time in their child’s classroom, to chat with teachers and other parents, to share your unique talents and gifts, and to join in our activities whenever time permits. The program is greatly improved through the help of parents ... time, energy, thought and creativity. Other ways of supporting the program will be offered throughout the year, such as attending work parties, working on fundraising, and helping with a variety of planned activities. Burleson Child Development Center’s staff is very grateful for the many ways that parents help make the center better for everyone.

    My signature below indicates that I have received a copy of the center’s policies and procedures and an orientation was conducted with me which covered all areas outlined in this orientation plan. I understand that the family plays a significant role in my child’s education, parent cooperation and participation betters my child’s learning experience.

  • Clear
  • Tuition Agreement

  • I agree to pay a registration fee of $100.00 per family. 

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  • We are excited to offer the safety, convenience and ease of Tuition Express®–a payment processing system that allows secure, on-time tuition and fee payments to be made from either your bank account or credit card.

    ELECTRONIC FUNDS TRANSFER AUTHORIZATION FOR BANK ACCOUNT and CREDIT CARD

    I (we) hereby authorize Burleson Child Development Center to initiate credit card charges to the below-referenced credit card account OR, initiate debit entries to my (our) checking or savings account, indicated below. To properly affect the cancellation of this agreement, I (we) are required to give 14 days written notice. Credit union members: please contact your credit union to verify account and routing numbers for automatic payments. Check with the center for accepted credit card types.

  • Credit Card Information

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  • Bank Account Information

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  • Clear
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  • Child Photo

    Please upload a photo of your child for us to use inside of our classrooms.
  • *please upload a clear, front-facing picture of your child.These pictures will be used for various things around the school such as classroom cubby tags, birthday walls, and our school family.

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