Day Care Application Form
Day Care Application Form
Please complete all sections of this form and provide accurate information to help us understand your child’s needs.
Child’s Information
Name
Date of Birth
Gender
-
Male
-
Female
Does your child have any allergies or health conditions?
If yes, please list
Parent/Guardian Information
Name
Relationship to Child
Phone number
Address
Emergency Contact
Name
Relationship to Child
Phone number
Authorized Pick-Up Persons
Name
Phone number
Name
Phone number
Additional Information
Provide any additional comments, notes, etc.
Thank you for completing the form.
We look forward to welcoming your child to [Your Company Name]!
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