• LES FINCH'S LEARNING TREE, INC

    4217 W. 16TH STREET
    CHICAGO, ILLINOIS 60623
    773-521-5434

  • *****ENROLLMENT APPLICATION*****

    Part 1
  • TODAY'S DATE:
     - -
  • Date of Birth:*
     - -
  • Gender:*

  • PARENTS/GUARDIAN INFORMATION

  • Date of Birth:*
     - -
  • Format: (000) 000-0000.
  • Marital Status:
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Date of Birth:
     - -
  • Marital Status:
  • Format: (000) 000-0000.

  • (Rev. 3/2026)

  • Enrollment Application

    Part 2

  • EMERGENCY CONTACT / PICK-UP AUTHORIZATION (Must be 18yrs or older and have an ID)

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

  • Unauthorized To Pick Up:

  • Enrollment Application

    Part 3

  • FAMILY

  • Names of other children in family:        
    Names of other children presently enrolled in this school
    Name of other children who formerly attended this school      
    Has child been previously enrolled in day/home care?     *       
    If yes, Name of School?
    Address:                             
    Phone Number:         
        Length of attendance?      
    Reason for leaving?      

  • PERSONAL HISTORY

  • Age child began walking?    *    
    Age child began talking?*
    Does child speak in complete sentences?      *   
    Does child primarily communicate using single words or short phrases?
                 
    Is child currently nonverbal?         
    Was child born prematurely?        
    If yes, how many weeks early?

  • TOILET HABITS

  • Is the child fully potty-trained?    *
    Does child wear diapers or pull-ups?         *     
    If Yes, How often are they changed?      
    Can child be relied upon to indicate bathroom wishes?      *   
    Does child need to go to bathroom more frequently than usual for age?      *   
    If yes, please explain:      

  • SLEEPING HABITS

  • What time does child usually go to bed?   *      
    What time does child usually wake up?   *   
    Does child take naps?      *      
    If yes, what time does child usually take nap?      
    How long is child's typical nap?   
    Does child have any special sleeping routines, comfort items, or sleep needs we should know about?         
    If yes, please explain:   

  • SOCIAL RELATIONSHIPS

  • Has child experienced playing with other children?      *   
    Check words that best describe your child:                                  Other:      
    Does child like be alone or around others:    
    Does child demand a lot of attention?        

  • Child Medical History

    1. Does child have any diagnosed medical conditions, development delays, disabilities, allergies, or health concerns that we should be aware of?      *   
      1. If yes, please explain:       
    2. Does child require medication to be administered during childcare hours?     *   
      1. If yes, please provide:
      2. Medication name:      
      3. Reason:      
      4. Administration Instructions:   
    • Note: A Medical Authorization Form signed by the child's physician & parent/guardian must be on file before medication can be administered.
    1. Does child have asthma?       * 
      1. If yes, does child require inhaler?         
    • Note: An Asthma Action Plan signed by the child's physician must be on file.
    1. Does child have any food allergies?      *   
      1. If yes, list ALL:      
    2. Does child have any dietary restrictions due to religious beliefs, medical needs, or family preferences?      *   
      1. If yes, please explain:      
    3. Does child require food substitutions?         
      1. If yes, please specify:         
    • Note: A Physician Food Substitution Form may be required.

  • HEALTHCARE PROVIDER INFORMATION

  • Format: (000) 000-0000.

  • PARENT AGREEMENT

  • I hereby consent to the enrollment of my child(ren) at Les Finch’s Learning Tree Inc.

    I understand that a non-refundable registration fee of $30.00 is required upon initial enrollment. This registration fee is a one-time fee and is not charged annually. I understand that children who continue in the program and enroll in the Kindergarten Program are required to pay a separate non-refundable Kindergarten registration fee of $30.00.

    I understand that tuition payments are due in advance according to the Center’s payment schedule. Failure to maintain current tuition payments may result in the discontinuation of childcare services.

    I understand that Les Finch’s Learning Tree Inc. conducts an annual mandatory raffl fundraiser between February and May. Each family is required to sell a minimum of $150.00 in raffle tickets. This fundraiser helps support the Center and assists in keeping tuition costs affordable for our families.

    I understand that additional fundraising opportunities may be offered throughout the year. Participation in these additional fundraising events is voluntary, but families are encouraged to support the Center whenever possible.

    I give permission for my child(ren)’s photographs and/or video images to be used by Les Finch’s Learning Tree Inc. for advertising, promotional, educational, and social media purposes.

    I give permission for my child(ren) to participate in field trips, educational activities, and excursions under proper supervision.

    I authorize the Center to seek emergency medical treatment for my child(ren) in the event of an accident or illness requiring immediate medical attention when I cannot be contacted promptly.

    By signing below, I acknowledge that I have read, understand, and agree to the terms and conditions of this Parent/Guardian Agreement.

  • Date*
     - -

  • GUIDANCE & DISCIPLINE POLICY

  • Our goal at Les Finch’s Learning Tree, INC is to assure the safety and welfare of all children enrolled in the day care programs. The staff at Les Finch’s Learning Tree, with the cooperation of the parents shall implement discipline methods that are appropriate and non-punitive for the child’s age and act of disobedience

    • Each classroom will develop clear, reasonable, consistent, and age-appropriate rules and expectations for children and to the extent possible, engage children in the rule-setting process
    • Work with children to help them solve problems, instead of imposing solutions
    • Reduce the potential need for discipline by anticipating and eliminating sources of trouble whenever possible
    • Respect and acknowledge children’s feelings
    • Discuss and work with parents in developing behavior improvement plans and concerns
    • Staff will respect and promote the unique identity of each child and family
    • Refrain from stereotyping on the basis of gender, race ethnicity, culture, religion, or disability

  • Discipline methods include:

    • The use of positive methods of child guidance
    • Verbal reminder of proper behavior
    • “Time out”-Student is removed from the environment where behavior problem has occurred for no more than 1minute per year of age
    • Parent conferences to discuss and develop appropriate discipline procedures for serious behavior problems
    • Procedures that are in accordance with Les Finch’s Discipline and Behavior Management Policies (LFLTRM.8000.400)

  • The following are prohibited in our center and anyone found non-compliant is subject to disciplinary action:

    • Corporal punishment or physical abuse
    • Emotional abuse, including shame, rejection, terrorizing, or isolation
    • Public or private humiliation
    • Abusive or profane language
    • Threats or the actual withdrawal of food, rest, or the use the bathroom
    • The use of basic needs as punishment or reward
  • Date
     - -

  • RELIGIOUS WAIVER

  • Les Finch’s Learning Tree Inc. is a Christian-based childcare center. As part of our daily routine, children participate in age-appropriate faith-based activities, which may include morning prayer, saying the Lord’s Prayer, reciting Psalm 23, and offering prayers before meals.

    Our goal is to teach values such as kindness, gratitude, respect, love, and compassion in a nurturing environment.

    By signing this agreement, I acknowledge that I have been informed of the Center’s Christian-based practices and understand that my child will participate in these daily religious activities while enrolled at the Center.

  • Date
     - -

  • REQUIRED ENROLLMENT DOCUMENTS

  • Please bring the following documents to Les Finch’s Learning Tree Inc. before your child’s first day of attendance. The Center will make copies and maintain the required documents in your child’s file.

    Required Documents:

    • Child’s Birth Certificate
    • Child’s Social Security Card
    • Current Physical Examination Form
    • Lead Screening Results
    • TB Test Results or TB Risk Assessment Questionnaire/Documentation indicating no test is required
    • Dental Examination Form (required for children 3 years of age and older)
    • Any applicable medical forms, including Asthma Action Plans, Allergy Action Plans, Medication Authorization Forms, or Food Substitution Forms
    • Any applicable custody or court documents

    Please note: A child may not begin attendance until all required enrollment and health documentation has been received and approved by the Center.  Please allow one (1) business day to review and process files.

  • REGISTRATION FEE PAYMENT ACKNOWLEDGEMENT

  • I understand that the $30 registration fee is required to process my child's enrollment at Les Finch's Learning Tree, INC.

    This fee is non-refundable and non-transferable.

  • My Products

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    Child Registration Fee. Non-refundable, one-time registration fee required for enrollment
    Child Registration Fee

    Non-refundable, one-time registration fee required for enrollment

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    Subtotal
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    Tax
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