Fillable Infant and Toddler Additional Enrollment Form

Infant and Toddler Additional Enrollment Information

This form should be used in addition to the Child Enrollment Form (PR-0185)

Oregon Department of Early Learning and Care
Childs Name
Nickname
Birthdate

MonthDayYear
Date
Current age
Name of Parents
Date filled out by parent

MonthDayYear
Date
Individual Interests
Does your child say any words? What do they mean?
What are childs favorite games toys and things to do?
Any information that might be important or helpful to caregivers?
Any pets in your home If yes type of pets?
Typical Daily Schedule: 7:00
8:00
9:00
10:00
11:00
12:00
1:00
2:00
3:00
4:00
5:00
Any special sleeping routines?
Does your baby like to be rocked?
Is your baby always put on his / her back to sleep?
When does your baby usually sleep?
How long is a typical sleep period?
Liquids
Milk
Brand
Type
Temperature
Amount/Serving Size
Juice
Any other liquids
Amount
Frequency
What does your child eat?
Types / Amount
Signature
Should be Empty: