Daycare Application Form
Welcome Message
Welcome to Milestones Play and Learn Center!We're thrilled to have you consider joining our family. To begin, we use a JotForm NOT as an official enrollment document, but as a helpful pre-review. It gives us a better understanding of your family's and child's needs, allowing us to serve you better from the start.
Hours of Operation
We're open Monday through Friday from 6:30 AM to 6:00 PM. Please note that the latest pick-up time is 5:45 PM.
Enrollment and Fees
For official enrollment, please request our official Registration Packet. This packet contains all the necessary forms and detailed information.For new students, there's a one-time $200 registration fee per child. Additionally, an annual $275 materials fee per child is collected.
Payment Plans
We understand that tuition and fees are a significant investment. Payment plans are available to help manage these costs. Please speak with one of our directors to discuss options that might work for your family.We can't wait to meet you and your child!
Full name of child 1
First Name
Middle Name
Last Name
Gender
Boy
Girl
Date of birth
-
Month
-
Day
Year
Date
Full name of child 2
First Name
Middle Name
Last Name
Gender
Boy
Girl
Date of birth
-
Month
-
Day
Year
Date
Full name of child 3
First Name
Middle Name
Last Name
Gender
Boy
Girl
Date of birth
-
Month
-
Day
Year
Date
Full name of child 4
First Name
Middle Name
Last Name
Gender
Boy
Girl
Date of birth
-
Month
-
Day
Year
Date
Mother's Name
First Name
Middle Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Father's Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Who has parental responsibility?
Mother
Father
Both
Other
Please specify
What is the best way to reach you in an emergency situation?
Which days and hours will your child or children need care?
Will your child be enrolled at our center during the entire year?
How long will you need childcare for?
Has your child/ren attended childcare in the past?
What communication channels do you prefer?
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What is your child's personality like? What is your child's behavior?
What is your child's interest and what gets them excited?
What is your child's dietary preferences and what is their favorite food?
Does your child/ren have any allergies?
Does your child/ren have any learning and developmental needs?
Does your child/ren have any medical needs or health issues we should know about?
Does your child/ren's immunization history and TB clearance up to date?
Signature of child care provider
Signature of parent
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Submit
Submit
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