EMERGENCY CONTACT INFORMATION

• You must provide the center with the current medical and immunization records for your child before the start date. The immunization records need to be updated annually.
• In case your child gets ill at the center, you will be notified as soon as possible and you must pick up your child immediately.
• If your child is absent from the center due to a communicable disease, the child may only return with a the physician's note indicating that the child is no longer contagious.

Click Next, Signature required for consent.

I(we) attest that all of the information on this application is accurate, and that I(we) have received the following information:

• Guidelines to Positive Discipline Policy
• Information to Parents Document
• Policy on the Expulsion of Children from Enrollment
• Policy on the use of Technology and Social Media
• Policy on the Management of Illnesses/Communicable Diseases
• Policy on the Release of Children
• Media Consent Form and Releasee for Minor Children

As the parent/guardian of the above named child, I certify that he/she is in a good physical health and may participate in the normal activities of the program and has no conditions of specific needs that require specific accommodations, unless otherwise indicated in the medical information provided above or an attached Universal Health Recor or a Care Plan for Children with Special Health Needs. 

As the parent(s)/legal guardian(s) of the above named child, I (we) attest that the information above is correct. I (we) authorize the child care center staff to obtain emergency treatment for my child and understand that I (we) shall be promptly notified.

Acknowledgement Statement

This statement acknowledges that the information I have provided is true to the best of my knowledge. This statement also acknowledges that I have received and understand KidStart Learning Center’s policies. I fully understand it is my responsibility to be familiar and comply with these policies. I further understand that the policies stated therein are guidelines that may be modified by the center if necessary.