• Child Enrollment Application

  • Enrollment Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Start Date
     - -
    2 digit month, 2 digit day, 4 digit year

  • Student Information

    • Child 1  
    • DOB*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Gender
    • Child 2 
    • DOB
       - -
      2 digit month, 2 digit day, 4 digit year
    • Gender
    • Child 3 
    • DOB
       - -
      2 digit month, 2 digit day, 4 digit year
    • Gender
    • Child 4 
    • DOB
       - -
      2 digit month, 2 digit day, 4 digit year
    • Gender
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    • 1st Parent/Guardian Information

    • Format: (000) 000-0000.
    • Format: (000) 000-0000.
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    • 2nd Parent/Guardian Information

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

      In the event there is any issue regarding custody of a child, the Child Care Center must be provided with Court issued Custody Papers that clearly describes the custody arrangements. Any person granted custody in such papers may pick up the child during the times that person has custody and may designate other people who are authorized to pick up the child at such times. The Child Care Center may not legally refuse the right to pick up a child to a person having custody of the child. Furthermore, any changes to the Court issued Custody Papers must be submitted to the Child Care Center immediately upon receipt. The Child Care Center and staff will not involve themselves with any Custody issues except when required by law.
    • Is Custody Prohibition Applicable?*
    • Yes 
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    • Emergency Contacts & Authorized Pickups (Other than Parents)

      Persons Authorized to pick up your child and/or contact in case of emergency if neither parent is available to assume responsibility for the child.
    • Rows

    • Medical Information

    • Type a question
      Rows

    • Health Statement

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

    • Emergency Treatment Policy

      As the parent(s)/legal guardian(s) of the above named child, I (we) attest that the information above is correct. Administration and staff will call Primary Contact listed on the Emergency Contact & Child Release Authorization Form. It is imperative for this reason that information on this form is updated as needed. It is understood that in some medical situation, staff may need to contact local emergency resources before primary contact. You authorize administration and staff to obtain immediate medical care, up to, and including transportation by local emergency resources, to the nearest emergency room. I(we) authorize the Child Care Center staff to obtain emergency treatment for my child and understand that I(we) shall be promptly notified.

    • Permissions

    • Walking Trip Permission*
    • PhotographPermission*

    • Consent to use Group Photos in Electronic Daily Activity Reports

      The Child Care Center takes photos of individual children and groups of children for electronic daily activity reports. These photos will not be used for any other purpose by the Child Care Center. Although we have a School policy against it, it is possible for individuals who receive group photos in an electronic daily activity reports to share these group photos through their personal social media accounts. For this reason, we ask that you specifically authorize whether we can include your child(ren) in any group photos shared through the electronic daily activity reports.
    • Select Photo Usage in Electronic daily activity reports*

    • Social Media Policy

    • Social media can be convenient, fun and rewarding way to share your life and opinions with family and friends. However, using social media involves certain risks and responsibilities. We ask the entire Child Care Center community to take the following reasonable steps to protect the safety and privacy of the children who attend the Child Care Center and their families. These policies apply to all forms of social media:
      • Do not post photographs or videos of any child (other than your own), any parent, or any employee at the Child Care Center on any website, blog or online social network without permission.
      • Do not post comments that are defamatory, harassing, threatening, or misleading about the Child Care Center faculty member, student, or a student’s family.
      • Do not post comments that invade the privacy of the Child Care Center faculty member, student, or a student’s family member.
      • Do not post the Child Care Center’s service marks, including logos, on any website, blog, or online social network without permission of the Child Care Center.

      I agree that I will not post or use any photographs or videos that I receive from or take at the Child Care Center that include children other than my own child(ren) in print, electronic or social media or any other form. This includes group photos that I receive as part of an electronic daily activity report. My agreement extends to photos or videos taken by any member of my family or any visitors that I bring to the Child Care Center.

      If I have any questions or concerns about my family’s experience at the Child Care Center, I will bring them directly to the owner, or to the director of the school.

    • Paperless Policy

      The staff and administration at the Child Care Center have always been concerned about our environment. In keeping with this, we have decided to go paperless. We will send notices and announcements to our families by email. Thank you for joining us in this small step to help the environment.

    • Receipts of Family Handbook

      In keeping with New Jersey’s Child Care Licensing Requirements, we are providing you the parent with this Parent Handbook. You have the right to visit and observe our center without having to secure prior permission; the Center has an obligation to comply with licensing standards; all citizens must report suspected child abuse/neglect/exploitation to the State Central Registry and Child Abuse Hotline at 1-877-652-2873. Please find the family handbook as below.

    • I understand and agree with all policies listed in family handbook. Specifically,

      • I understand that full tuition is due regardless of holidays, snow days, short term illnesses, or vacations.
      • All returned transactions will be assessed a penalty to cover banking fees.
      • I understand the Expulsion Policy and Information to Parents Document made by the Office of Licensing (included in the Parent Handbook).
      • I understand that if my child has allergies or food sensitivities their name and allergy information will be posted in the classroom.
      • Withdrawal during the school year requires 15 days written notice.
      • 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
      • Policy on the Methods of Parental Notification

       

    • Tuition Charges (Current & Future) and Policy agreement

      Please see attached Tuition Charge aggreement.
    • Select the days your child will attend the school

    • Universal Health Record

      Please download and fill out the Universal Health Record form below and have it signed by Health Care Provider.
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    • Calendar

      Please refer to attached school calendar.
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