www.childrenschoicepreschool.com Executive Director: Jennifer House □ 1465 E. Madison Ave El Cajon, CA 92019 (619) 442-4014 □ 1268 N. Second St. El Cajon, CA 92021 (619) 442-1685 □ 9748 Los Coches Rd Ste #9 Lakeside, CA 92040 (619) 561-1178 CHILD REGISTRATION PACKET Child’s Name: Date of Birth: Date Registered: Start Date: Group/Room: Account Key: Days Attending: M T W TH F Full Half Hours: Tuition per week: Registration fee paid: Summer Activity Fee: $145-School Age $55-Preschool Alternative Payment Provider: Required Forms: □ Emergency Information □ Consent for Medical Treatment Allergies to food or milk? Yes or No □ Parent/Center Contract (circle one) □ Enrollment Questionnaire □ Physician’s Report □ Immunization Record Please Bring In: □ Parent Handbook ● Immunization Record □ Sick Policy ● Fitted Crib Sheet and Blanket □ Parent’s Rights Form ● Extra change of clothes □ Child’s Rights Form ● Diapers and Wipes (if applicable) □ Assessment Form ● Baby Formula (if applicable) □ Blue Immunization Card □ Photo Release
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www.childrenschoicepreschool.com Executive Director: Jennifer House
□ 1465 E. Madison Ave
El Cajon, CA 92019
(619) 442-4014
□ 1268 N. Second St.
El Cajon, CA 92021
(619) 442-1685
□ 9748 Los Coches Rd Ste #9
Lakeside, CA 92040
(619) 561-1178
CHILD REGISTRATION PACKET
Child’s Name: Date of Birth:
Date Registered: Start Date:
Group/Room: Account Key:
Days Attending: M T W TH F Full Half
Hours:
Tuition per
week: Registration fee
paid: Summer Activity
Fee: $145-School Age
$55-Preschool
Alternative Payment Provider:
Required Forms:
□ Emergency Information
□ Consent for Medical Treatment Allergies to food or milk? Yes or No
□ Parent/Center Contract (circle one)
□ Enrollment Questionnaire
□ Physician’s Report
□ Immunization Record Please Bring In:
□ Parent Handbook ● Immunization Record
□ Sick Policy ● Fitted Crib Sheet and Blanket
□ Parent’s Rights Form ● Extra change of clothes
□ Child’s Rights Form ● Diapers and Wipes (if applicable)
Persons Authorized to Pick up Child 1 ) Name: Relationship:
Address: Phone #
2 ) Name: Relationship:
Address: Phone #
3 ) Name: Relationship:
Address: Phone #
4) Name: Relationship:
Address: Phone # *PLEASE REMEMBER: All persons authorized to pick up your child MUST have a valid identification card with them in order for the child to be released.
PHOTO RELEASE
Yes, I hereby give Children’s Choice Learning Connection permission to
use my child’s photograph and likeness in all forms of media for
advertising, trade, and any other lawful purposes.
I attest that I am the parent/guardian of the child(ren) stated below.
I have read this release form and approve of its terms.
Child(ren) Name(s):
Parent/Guardian Printed Name:
Parent/Guardian Signature:
Date:
No, I, , do not give my permission for
my child’s photo to be used for any purposes.
Parent/Guardian Signature:
Date:
Permission
to apply
Sunscreen I give permission for the staff at Children’s Choice Learning
Connection to apply sunscreen / sun block to my child. I
understand that Sunscreen / Sunblock cannot be shared with
other kids/staff.
PARENTS MUST PROVIDE SUNSCREEN / SUN BLOCK
Child’s Name:
Parent’s Signature:
Infant Needs and Assessment Plan
Date: _______________
Next Assessment Due: _____________________ (To Be Updated Every 3 Months) Child’s Name: _____________________________ Date of Birth: ____________________________ Mother’s Name: ___________________________ Daytime Phone: __________________________ Father’s Name: ____________________________ Daytime Phone: __________________________
Feedings: Bottle ____ Cup _____ Type of Formula ______________ Does your child need to be burped? ______ Are there any feeding problems? If so, please describe: _______________________________________
Are there any food/liquid your child dislikes? Please list: Are there any food allergies? Please list: _____________________________________________ _________________________________ _____________________________________________ _________________________________ _____________________________________________ _________________________________ Feeding Schedule: Fluids Schedule: Type Amount Time Type Amount Time __________ __________ __________ __________ __________ ________ __________ __________ __________ __________ __________ ________ __________ __________ __________ __________ __________ ________ __________ __________ __________ __________ __________ ________ __________ __________ __________ __________ __________ ________
Diapering: Is your child prone to diaper rash? ___________________ How is it treated? ______________________
Sleeping: Does your child need a special toy or blanket to sleep with? ___________________________________ Does your child need to be rocked to sleep? _________________________________________________ What is the best way to comfort your child? ________________________________________________ Please add any other information that will help us understand your child’s sleeping habits: ___________
Pets at Home: Dog __________ Cat __________ Fish __________ Other _____________________________
Other Caregivers: Grandparents ___________________ Babysitter ___________ Other ______________________
Potty Training: Parent and Staff Agreement:
1. At Children’s Choice, we will begin to train at child at 24 months old. It is agreed by the parents to be consistent with the time to begin training.
2. Parents and staff will involve the toddler in taking down his/her own pants, zipping, and unbuttoning. Parents will decide how we are to train males to urinate (will he hold penis and stand or sit and hold penis down).
3. Parents will understand that the toddler will not immediately be able to wipe his/her own bottom after a bowel movement. Staff will assist until skill is learned.
4. Staff will not force a child to sit on a toilet. Scolding will not take place. Trips to the potty will be short and fun.
5. Staff will provide instruction and assistance in hand washing after toileting.