• Parent Enrollment & Policy Agreement Form

    Complete this form to enroll your child at Beanstalk Childcare & Academy and acknowledge all policies, procedures, and fee agreements.
  • Format: (000) 000-0000.
  • Child's Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Please review and acknowledge the following policies and fee schedule. You are responsible for all registration, tuition, late pickup, transportation, and activity fees as described in the Beanstalk Childcare & Academy Parent Handbook. For detailed fee information, visit https://www.beanstalk-childcare-academy.com or contact the office at 402-932-5909.
  • Date (Registration Agreement)*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date (Areas of Conduct)*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Our Mission Statement:

  • Our Mission Statement:
    At the Beanstalk Childcare Academy, Our mission is to support and enhance the
    natural development of children six weeks to twelve years in age.
    To accomplish this, we look for caring, experienced and educated staff. Our Staff is trained to use
    balanced and developmentally appropriate curricular, modeling and redirection throughout the day. We
    also work with our parents and the community to provide our children with the most universal and
    diverse opportunities to grow and succeed.
    Dear Parents,
    Enclosed in your packet are several papers that will need to be filled out and returned prior to your child
    starting services. Please read all forms carefully before signing. Since there are a limited numbers of slots
    this should be done as soon as possible.
    When registering your child/children for the Beanstalk Childcare & Academy there is a $45.00
    non-refundable registration fee per family. This fee is good for one year. A $30.00 fee is assessed in
    subsequent years.
    Our daycare is a pre-pay program. The cost for services is as follows: For daily service less than 4 hours,
    the rate for all students is $30.00/hour. For infants, ages 0-18 months, the daily rate (4 hrs or more) is
    $75.00. For toddlers, ages 18mths-3.11months, the daily rate is $70.00. For preschoolers,
    4yrs,-kindergarten, the daily rate is $65.00. For school age, kindergarten and older, the daily rate is
    $60.00. Please remember that 4-8 hours constitutes a full day. After 8 hours the half day rate will be
    added to current charges for the day. There is a late charge of $25.00 per child for every 15 minutes your
    child is in daycare past your schedule time , plus an additional fee and possible termination of services if this
    becomes a problem.
    Summer Activity Fee Notice
    To help support the exciting activities and special events we have planned for the summer months, a
    $75.00 activity fee
    will be applied for each of the following months:
    June, July, and August
    .
    This fee helps cover the cost of field trips, special visitors, outdoor experiences, and other enrichment
    activities that make summer fun and engaging for the children.

  • Transportation Authorization Form

  • Does your child need transportation*
  • Transportation Authorized For:
  • Transportation Schedule
  • I authorize Beanstalk Childcare & Academy and its authorized staff to transport my child as indicated above. I understand that transportation is subject to availability and scheduling. I understand that my child must follow all transportation safety rules, including remaining properly secured in the appropriate seat or restraint while the vehicle is moving. I will notify Beanstalk Childcare & Academy of any changes to my child’s school or transportation schedule.

  • Physician Information Form

  • Format: (000) 000-0000.
  • Diaper Cream Authorization Form

  • Permission Granted*
  • Sunscreen Authorization Form

  • Permission granted*
  • Custody Agreement Acknowledgment

  • Custody Agreement Acknowledgement*
  • Parent Handbook Acknowledgment

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Childcare Agreement

  • Registration Agreement

     I understand that during the winter months, the daycare may be closed due to bad weather, and I will call the daycare before bringing my child.

    2. I understand that I am responsible for payment of contracted fees every week. (Unless other arrangements have been made with the director)*Please see below, I understand that my child may be excluded from the program if my bill is delinquent. I will give one week's notice of withdrawal from the program.

    3. If my child is having problems adjusting to the program, a conference will be arranged between the staff and me.

    4. The Beanstalk Childcare & Academy staff will assume responsibility of my child from the time she/he arrives at the program until dismissal time. * The child must be signed in upon arrival and be signed out upon departure by an authorized person.

    5. I will contact the program staff by telephone if my child is to be released to someone other than the authorized pick-up person. I will describe that person and make sure they have proper I.D

     6. I permit my child to participate in walks and field trips. Permission slips will be distributed before each trip.

    7. If a medical emergency arises, the Beanstalk Program staff will first attempt to contact me. If I cannot be reached, the staff will contact the child’s doctor. If the emergency is such that immediate hospital attention is necessary, the Beanstalk staff should call the rescue squad.

    8. My child must be picked up at your scheduled time. Any child who has not been picked up will be automatically charged $15.00 per child for every 15 minutes or portion thereof past the scheduled time. The second time will be $25.00 per child, and the third time will be $35.00 per child, and a conference with the director.

    9. If any child is not picked up by the scheduled time, the program staff will call the “person authorized to sign out/pick up “as listed on the Emergency Medical release form.

  • Potty Training
    If the child has had success in potty training at home, the provider may attempt to provide assistance in the potty training process at their discretion during daycare.

    The parent /Guardian agrees to keep the child in diapers or “pull-ups” until the child has demonstrated the ability to remain “accident –free” for a period of at least 2 weeks at home.

     Guidance Policy
    The technique of “timeout” will be used in the event the child misbehaves. The provider will use the opportunity to explain why the child’s actions were inappropriate and to give the child time to reflect upon their actions.

    If a child becomes abusive or poses a danger to the other children, the provider reserves the right to require immediate pickup and or termination of this agreement in the interest of safety.

     

     

  •  Policies and Procedures
    The Beanstalk Childcare and Academy is committed to providing quality care for your child/children. In order for us to provide this kind of care, we have established certain rules and requirements. Please read the policies and procedures very carefully so that you are completely familiar with them. If you have any questions, please feel free to discuss them with the Director at any time. Her name is Gabbie Hervey and the direct number is 402-932-5909


     Enrollment
    All forms enclosed in the enrollment packet must be returned completely filled out before any child enters The Beanstalk Program. All forms are subject to yearly renewal and must be kept up-to-date.
    All children enter The Beanstalk on a 2 week trial basis, to ensure proper adjustment. During that 2 week period, either party may cancel with a one day notice. After the trail period either terminating party must give aoneweek notice.If a one week notice is not given bythe parent, the parent will be responsible for at least a one week fee for each child.
    The child/children and his/her parent(s) must be present during the interview and tour.


     Hours of Operations

    The Beanstalk Childcare and Academy was developed to care for children 6 weeks to 12 years of age. We are open Monday-Friday , 7:00a.m to 12:00am. Saturday 7:00am - 6:00pm. We will be closed on the following holidays:  Should these days fall on a weekday, you will be charged for the day.New Year’s Days, Martin Luther King’s Birthday, Memorial day, July 4th , Labor Day, Thanksgiving Day and the Friday after, and Christmas Day.


    You will receive a 5 day notice if there are any changes to the program’s days or hours.


     Meal Times
    Breakfast, lunch, afternoon snacks, and dinner will be available. Children will be encouraged to try foods but will not be forced to eat.

     

     Termination of Services

    We require a 1 week advance notice in writing, for the withdrawal of your child/children. Failure to do so will result in additional billing charges. Vacation- If you will be gone 1 week or longer a 2 week advance notice for vacation time is needed.  With an advance written notice we will not charge you for 1 week of vacation. If you will be gone longer you will need to continue to prepay as agreed in your contract, to hold your child’s active status at the program.


     Illness and Medication

    Parents should notify the staff if their child/children have been ill during the night, morning or over the weekend prior to coming to the center. No childwill be allowedin theprogram 

     with a contagious disease or running a fever. Symptoms of contagious disease are:

    Diarrhea or vomiting 2 or more times in a 24 hour period.
    Body rashes not associated with diapering, heat or medicine.
    Drainage from the eyes.
    Sore throat, especially associated with a fever or swollen glands
    Appearance/ Behavior, unusually tired, lack of appetite, difficult to awaken, and confused or irritable.
    A doctor’s note must be presented stipulating that the child is no longer contagious before the child will be accepted back.

    Should your child become ill during the day you will be asked to come and pick up your child immediately? You will also be notified immediately if your child comes in contact with any


    contagious disease. A signed authorization is required for all medication administered to your child. Please sign one even for aspirin. Prescription medication must be presented in the original bottle obtained from the pharmacy or doctor’s office. Scratches and scrapes are inevitable when children are playing or learning to walk. Minor accidents will be treated with antiseptic and a Band-Aid unless you have requested that they not be used. For anything more serious or in case of an emergency you will be notified immediately. If necessary a rescue squad will be called and you will be able to meet the child care instructor and your child at the hospital. We will have the necessary Emergency Release forms signed by you if you cannot be contacted immediately. Each day your child will be checked for bumps and bruises. We ask that you tell us in the morning if your child has any marks which should be explained or if your child did not sleep well the night before. This will help us anticipate any changes in personal or irritability during the day.

  • 2 *Although not all acts of misconduct can be itemized, the following is an enumeration of some of the main areas of conduct that may lead to disciplinary action, such as revoking privileges, probation, suspension, or expulsion from the Childcare Program.

    1. Use of violence, force, noise, coercion, threat, intimidation, fear, insubordination, or other similar conduct in a manner that constitutes an interference with the Childcare Program.

    2. False communication, verbal or written, of the presence of a bomb or other explosive device.

    3. The willful causing or attempting to cause damage to another’s property.

    4. Stealing or attempting to steal another’s property.

    5. Causing or attempting to cause physical injury to him/her or others, including the throwing of objects or materials which could cause physical injury, except that such injury results from accident, self-defense, or other action undertaken on the reasonable belief that it was necessary to protect some person.

    6. Threatening or intimidating any person for the purpose of, or with the intent of, obtaining money or anything of value from such person.

    7. Engaging in the use of tobacco or the unlawful selling, use, possession, or dispensing of alcoholic beverages, narcotics, drugs, or other controlled substances. 8. Using language which, by childcare standards, is considered vulgar or obscene. 9. Causing a fire alarm.

    10. Public indecency (as defined in the state statute).

    11. The use of language notes or handouts that contain racial or ethnic slurs or derogatory statements addressed to others.

  • Hours of Operations

  •  Hours of Operations

    The Beanstalk Childcare and Academy was developed to care for children from 6 weeks to 12 years of age. We are open Monday-Friday, 7:00 a.m. to 12:00 am. Saturdays 7:00 am-6:00 pm

    We will be closed on the following holidays: New Year’s Day, Martin Luther King’s Birthday, Memorial Day, July 4th, Labor Day, Thanksgiving Day, and the Friday after, and Christmas Day. Should these days fall on a weekday, you will be charged for the day.


    You will receive a 5-day notice if there are any changes to the program’s days or hours.

  • Enrollment Form

  • If parent is separated or divorced, please indicate whether the other party has permission to have contact with the child at “The Beanstalk” Yes No*
  • Emergency situation

  • Format: (000) 000-0000.
  •  

    We, the undersigned, parent(s) legal guardian(s) of the minor child above, hereby consent and authorize the staff members of The Beanstalk Childcare & Academy to take any and all steps necessary to see that our/my child receives necessary medical treatment in the event of an emergency, if they are unable to contact me/ us at the time of the emergency situation. This authorization includes contacting our/my family physician or dentist, or another doctor or dentist if the individuals named above are unavailable, taking the child to the hospital emergency room to receive medical care, and authorizing the medical personal to provide necessary emergency care. This authorization shall remain in effect for as long as our/my child is being cared for at The Beanstalk Childcare & Academy.

     

     

  • Emergency Transportation and Treatment Authorization 

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • In the event that I cannot be reached to make arrangements for emergency medical or dental care for my child, I (grant/decline) permission for:*
  • Photo Release

  • Beanstalk Childcare & Academy may take photographs of children during daily activities, special events, and learning experiences. These photographs may be used for in-house displays, classroom activities, and to share examples of the programs and activities offered at our center. A photo may also be kept in the child’s file for identification purposes.

     


    From time to time, photographs may also be shared on our official Beanstalk Childcare & Academy social media pages or promotional materials to highlight classroom learning and special moments.

     


    We respect every family’s preference and will only use photographs according to the permission granted below.

    Please select one option:

  • Can we use your child's photo for display, inhouse and social media?*
  • Authorization to Leave Childcare Center

  • Authorization to Leave Childcare Center
    Beanstalk Childcare Program

    For your child’s safety, children will be released only to a parent/guardian or to individuals listed below. In an emergency, a child may be released to a person not listed below only after the parent/guardian has notified the center in person or by phone.

     

     

     

     

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Authorized Individuals to Pick Up My Child
    Instructions: Please list all individuals authorized to pick up your child. Identification may be required at pick-up.

  • Rates and Fees

  • Rates and Fees
    The childcare rate for your child will be determined based on your child’s age, schedule, and type of care needed. The Director will provide you with your confirmed childcare rate before care begins.

    Payment Schedule
    Childcare payments are due weekly. Families are responsible for making payments according to the payment schedule established by Beanstalk Childcare & Academy.

    Rate Changes
    Families will receive written notice before any changes are made to their childcare rate.

    Child Vacation Time
    Each child is allowed one week of vacation time per year. Please provide at least two weeks’ notice before using vacation time. Any applicable vacation discount will be discussed and confirmed by the Director.

    Acknowledgment

    By selecting “Yes” below, I acknowledge that I have read and understand the Rates and Fees policy for Beanstalk Childcare & Academy.

    I have read and understand the Rates and Fees policy.

  • Beanstalk Childcare Weekly Schedule Submission

  • Please submit your child’s schedule for the upcoming week.
    Forms are due each Friday. If your schedule changes, please resubmit the form or contact us directly.

    ✅ Save this link and use it every week.
    📅 Weekly schedule submission is required – even if your child’s schedule remains the same.

    https://docs.google.com/forms/d/e/1FAIpQLSfDQfaNy8AQWA1ipDLM-LIEIwXck0MpYgca0iWfYoYZDJk0kw/viewform?usp=header

     

    NO CALL/NO SHOW POLICY
    We schedule staff based on each child's attendance. If a child is scheduled but does not attend without prior notice "(no call/no show") a $50 fee will be added to your account.

     

    If you have any questions, feel free to contact Gabbie at 402-686-7243.

  • Non-Prescription Medication Permission

  •  

     

    I authorize Beanstalk Childcare staff to administer the following non-prescription items to my child on an as-needed basis and in accordance with the manufacturer’s instructions:

     


    Baby wipes, baby lotion, antibacterial ointment, petroleum jelly (Vaseline), acetaminophen, band-aids, decongestant, diaper ointment/cream, sunscreen, insect repellent, ibuprofen, and anti-itch cream.

     


    These items may be used for routine care, minor injuries, or comfort while my child is in attendance.

     

     

  • Please indicate your permission below:*
  • Weekly Schedule Policy

  • Weekly Schedule Policy

     

    Weekly schedules must be submitted no later than Friday at 6:00 PM for the upcoming week of care.

     


    To help families remember, reminder text messages will be sent on Thursday and Friday at 12:00 PM each week.

     


    Submitting schedules on time allows us to properly plan staffing and classroom ratios to ensure safe and quality care for all children.

     


    If a schedule is not received by Friday at 6:00 PM, your child will not be scheduled for care the following week and attendance cannot be guaranteed.

     


    If you have any changes after submitting your schedule, please notify the daycare as soon as possible.

     
     

  • Current Health Status

  • Health information

  • Please complete the following health information for your child. Provide as much detail as possible to help us care for your child safely.

  • Please send shot records to fax number 402-932-7717 or gabbie.beanstalkchildcare@outlook.com 

  • Ongoing Medical Needs Is your child currently taking medication for any ongoing medical problems?*
  • Allergies Does your child have any allergies?*
  • Emergency Transportation and Treatment Authorization

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Authorization Statement

    In the event that I cannot be reached to make arrangements for emergency medical or dental care for my child, I authorize the child care provider to obtain emergency treatment for my child as deemed necessary. I understand that every reasonable effort will be made to contact me prior to taking action.

     

    I authorize the child care provider to take my child to the nearest hospital, medical, or dental facility for treatment for any accident or illness as deemed necessary by the provider. I accept responsibility for all medical treatment and ambulance expenses.

  • Emergency Medical Treatment Permission*
  • Emergency Contact List

  • Please list individuals who may be contacted in case of emergency if a parent or guardian cannot be reached. These individuals may also be authorized to pick up your child if necessary.

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Behavior Guidance and Suspension Policy

  • At Beanstalk Childcare & Academy, we are committed to providing a safe, respectful, and structured environment for all children and staff. While we understand that children are still learning appropriate behaviors, repeated or severe behavioral issues will be addressed promptly.

     
    If a child is exhibiting ongoing behavioral concerns, the following steps will be taken:


    Parent Notification and Pick-Up
    If a child is having significant behavioral issues that disrupt the classroom or pose a safety concern, the parent/guardian will be contacted and required to pick up the child from the center.
    Three-Day Suspension
    If behavioral issues continue after the initial incident, the child will be placed on a three (3) day suspension from the daycare.
    One-Week Suspension
    If additional behavioral incidents occur following the three-day suspension, the child will be placed on a one (1) week suspension from the daycare.
    Termination of Care
    If behavioral issues persist after the above steps, the child may be disenrolled from Beanstalk Childcare & Academy and will no longer be eligible to attend.

     


    We encourage open communication with families and will work collaboratively to support positive behavior. However, the safety and well-being of all children and staff remain our top priority.

  • Biting Prevention and Response Policy — Policy adopted October 17, 2026. Applies prospectively after the parent/guardian receives and acknowledges this policy.

  • Acknowledgment: I have read and understand the Biting Prevention and Response Policy, including the incident response, confidentiality, family participation, and possible pickup, suspension, or termination procedures. I understand this policy applies prospectively after my receipt and acknowledgment.
  • input261
     - -
    2 digit month, 2 digit day, 4 digit year
  • Anaphylaxis Response Policy Acknowledgement

  • Does your child have any known food, medication insect, environmental or other allergies*
  • Parent/Guardian Acknowledgment
    I acknowledge that I have received, reviewed, and understand Beanstalk Childcare & Academy’s Anaphylaxis Response Policy as provided in the Parent Handbook. I understand that Beanstalk Childcare & Academy will follow its established emergency procedures in the event of a suspected severe allergic reaction or anaphylactic emergency

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Beanstalk Childcare & Academy is committed to protecting children and staff. Biting can occur while young children are developing communication and self-regulation skills. We respond promptly to every incident and work to reduce recurrence; no policy can guarantee that biting will never occur. Immediate Response and Care: Staff will safely interrupt the incident, comfort and provide appropriate first aid to the injured child, and calmly redirect the child who bit. Staff will promptly notify each child's parent/legal guardian separately and document the incident and care provided. For a bite that breaks the skin, staff will promptly notify the injured child's parent/guardian and recommend contacting the child's healthcare provider. Emergency assistance will be obtained when needed, and required reports will be made. Privacy: Families will receive information about their own child. The other child's name and private records will not be shared with families. Information may be provided to licensing authorities, insurers, medical responders, or others as legally required or authorized. Prevention and Family Partnership: Staff will review possible triggers, provide closer supervision and age-appropriate redirection, and adjust routines or the environment as appropriate. Repeated biting will result in a parent/guardian conference and a written prevention and support plan with a review date. Families are expected to participate in this planning. Children will not be bitten back, physically punished, humiliated, or labeled. Pickup, Suspension, and Termination: A single bite does not automatically result in permanent removal. The Director may require immediate pickup when an incident causes serious injury or an immediate safety risk cannot be managed safely. Return arrangements will be discussed with the parent/guardian and documented. Repeated or severe incidents may result in temporary suspension or termination when an individualized assessment shows that safety cannot be maintained with reasonable supports and modifications. Decisions will consider age, development, severity, frequency, documented interventions, and applicable licensing and disability requirements. A serious immediate safety risk may require action without progressing through every suspension step. The Director will document the reason, notify the parent/guardian in writing, and explain any return conditions. Reasonable modifications will be considered where required by law. Suspension or termination will not be based solely on a disability or diagnosis. Relationship to Other Policies: This section governs biting incidents if its individualized response process differs from the general Behavior Guidance and Suspension Policy. It does not excuse unsafe behavior or waive the center's duty to supervise and respond appropriately.
  • Should be Empty: