Clone of Kid Connect Registration

  • Preschool Registration

  • Gender*
  • Date of Birth*
     - -
  • Does your child have allergies?*
  • Child's Special Care Needs (Check all that apply)
  • Does your child have diagnosed food allergies?*
  • Food Allergy Emergency Plan Submitted Date:
     - -

  • Child day care operations are public accommodations under the Americans Disabilities Act (ADA), Title III. To learn more visit: https://www.ada.gov/resources/child-care-centers/. If you believe that such an operation may be practicing discrimination in violation of Title III, you may call the ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY).

  • Date Signed*
     - -

  • Mother/Guardian Contact

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Marital Status
  • Do you have custody of your child?
  • Are you allowed to pick up the child?

  • Father/Guardian Contact Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Marital Status
  • Do you have custody of your child?
  • Are you allowed to pick up the child?

  • Approved Pick Up List

    Please attach a copy of all parties' driver's licenses that will be picking up the child.

  • Format: (000) 000-0000.
  • Browse Files
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  • Format: (000) 000-0000.
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Format: (000) 000-0000.
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof

  • Emergency Information

  • Format: (000) 000-0000.

  • Emergency Contact Information

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

  • Kid Connect Program Options & Drop-In Form

  • KidConnect offers 3, 4, and 5-day program options. With the enrollment of (child's name) in KidConnect Preschool, I agree to comply with the following program options agreement:

    1. My child will only attend the days of the week I have selected.
    2. If I want my child to attend a day outside of their scheduled program days, I understand I must inform the KidConnect admin staff at least 24 hours in advance, that day may not be available, and there will be a non-refundable, $50 drop-in fee.
    3. If I would like to change my daily option, I must inform the KidConnect admin staff 2-weeks prior to the next monthly billing cycle.
    4. Daily program options may not be changed after the 1st of the current month.
    5. If a holiday or school closing occurs on one or more of your child's scheduled days, there are no make-up days. If you would like your child to attend additional days, there will be a $50 non-refundable, drop-in fee.

  • Please select the days your child will be attending for the appropriate program option.

  • 3-Day Program:
  • 4-Day Program:

  • Final Question: Where would like us to send a completed copy of your registration documents?

  • Should be Empty: