Drop In Form

Drop In Form

Little Me with Daycare & Preschool LLC
Open Monday - Friday 7:00 am - 5:30 pm
Parent/Provider Contract
1 Child’s name

First NameLast Name
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Allergies / Medical / Mental conditions

Daycare Schedule for Child 1

Rows	Date	Time In	Time Out
Monday
Tuestday
Wednesday
Thursday
Friday

2 Child’s name

First NameLast Name
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Allergies / Medical / Mental conditions

Daycare Schedule for Child 2 (If the same please skip schedule)

Rows	Date	Time In	Time Out
Monday
Tuestday
Wednesday
Thursday
Friday

PARENT INFORMATION
Mother's First and Last name
Mother's phone number
Format: (000) 000-0000.
Mother's address
Mother's work address and phone number
Format: (000) 000-0000.
Mother's email
example@example.com
Father's First and Last name
Father's phone number
Format: (000) 000-0000.
Father's Address
Father's work address and phone number
Format: (000) 000-0000.
Father's email
example@example.com

EMERGENCY CONTACTS/PICK UP LIST:

Please list below the persons authorized to pick up your child in the event of an emergency or when you cannot get here on time:
First and Last name
Relationship
Phone numbers
Format: (000) 000-0000.
Please list below anyone who is not allowed to pick up a child. In the event that you wish to list the other parent, PLEASE make sure that I have legal documents to prevent them from doing so, otherwise I can not stop them from taking his/her child from daycare.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Attention! Drop-In Policy

Please note that Drop-In payments are non-refundable. This means that once you make a payment or deposit, it cannot be returned under any circumstances, even if you cancel or change your plans. We reserve a spot for your child on the requested date, which is why this policy is strictly enforced.

To reserve a Drop-In spot, payment must be made at least one day in advance of your child’s attendance.

Important Reminders:

Latest drop-off time for Drop-In care is 10:00 AM. We cannot accept children after this time.

Late Pick-Up Fee: A fee of $2.00 per minute per child will be charged if your child is picked up after the agreed-upon pick-up time.

Thank you for understanding and helping us maintain a smooth and organized daycare environment.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

How did you hear about us
WE APPRECIATE YOUR BUSINESS.

THANK YOU FOR CHOOSING

LITTLE ME WITH DAYCARE AS YOUR CHILDCARE.
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