Lil Pirates of Granbury, LLC
Student Enrollment Application updated 1/7/26
Completion of this application is required prior to enrollment. Submission does not guarantee acceptance. A formal enrollment form must be completed and accepted to begin care. Lil Pirates of Granbury, LLC does not discriminate in enrollment on the basis of race, color, national origin, religion, sex, or disability, in accordance with applicable law. Acceptance is based on program availability and the ability to meet a child's needs within licensing standards.
CHILD INFORMATION
Child's Full Legal Name:
Date of Birth:
-
Month
-
Day
Year
Date
Age:
Home Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
PARENT / LEGAL GUARDIAN INFORMATION
Parent / Guardian #1
Name:
Relationship:
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Parent / Guardian #2
Name:
Phone:
Format: (000) 000-0000.
Email:
example@example.com
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HEALTH INFORMATION
Allergies:
No
Other
Medical Conditions:
No
Other
Medication required during care?
No
Yes
If yes, medication authorization forms are required prior to attendance.
ENROLLMENT DETAILS
Requested Start Date:
-
Month
-
Day
Year
Date Picker Icon
Days Attending:
Monday
Tuesday
Wednesday
Thursday
Friday
Hours Needed:
Full Day
Other
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DEVELOPMENTAL / SUPERVISION INFORMATION
Has your child been diagnosed with or received services for developmental, behavioral, or learning needs?
No
Yes (explain):
Does your child require more supervision beyond standard classroom ratios? This information is requested solely to determine whether we are appropriately staffed, trained, and equipped to meet a child's needs in compliance with Texas Minimum Standards.
No
Yes (explain):
EMERGENCY MEDICAL AUTHORIZATION
I authorize Lil Pirates of Granbury, LLC to obtain emergency medical treatment for my child if I cannot be reached.
Yes
No
Failure to authorize emergency medical care may result in the inability to enroll or continue care, as required for child safety.
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HEALTH SCREENINGS/MEDICAL FORMS ACKNOWLEDGMENT
Required health screenings and medical forms such as Immunization records (or a waiver) must be completed and kept current in accordance with Texas Minimum Standards.
CHILDCARE HISTORY
What daycare is your child currently attending?
What Daycares has your child attended?
Information is used solely for continuity of care and enrollment planning.
PARENT ACKNOWLEDGMENT & SIGNATURE
I certify that the information provided is accurate and complete. I understand that, if accepted, a formal enrollment process must be completed before care begins.
Signature:
Date:
-
Month
-
Day
Year
Date
Printed Name:
How did you hear about us?
How did you hear about us?
Facebook
Tik Tok
Instagram
Website
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Good2CU
Other:
Friend (give name for their referral credit if applicable):
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