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KIDS SAY SILLY THINGS
CHEERLEADING
POEMS
ART AREA
INSPIRATIONAL
CRAFTS
LINKS
INTRODUCTION
SAMPLE FORMS
HELPFUL HINTS
RECALLS
WEB SITES
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| SAMPLE FORMS |
| Please copy or print the forms you need |
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| EMERGENCY CONSENT FORM |
| I / We hereby authorize ___________________ to give consent for all medical and / or surgical treatment that may be required for our child's absence from ______ until _____. Child's Name:_________________ Child's Birth Date:____________ Chronic Illness:______________ Allergies:___________________ Current Medications:_____________ Date of Last Tetanus Immunization:___________ Physician Name:______________ Physician Telephone Number:______________ Home Address:__________________ Telephone Number:______________ Additinal Telephone Number:______________ Employer:____________ Telephone Number:________________ Health Insurance Co.:________________ Member Number:_______________________ Group Number:_______________________ Nearest Relative:_________________ Telephone Number:_________________ Additional Relative:________________ Telephone Number:__________________ __________________________________ Parent / Guardian Date |
| CHILD CARE CONTRACT |
| Parent or Provider may terminate child care services during the trial period with a 24 hour notice. Payment of one week in advance is required to begin child care services or to hold a space. The starting date of child care services will begin ___________ Hours agreed upon are as follows: Monday thru Friday ______am to ____pm Part-time Mon____ Tues_____ Wed______ Thurs______ Fri_____ The charge for the care of the child / children is $_______ per _____ The fee is due on ____________ Will be considered late if payment is not made by_________ A late charge of $_______ for ever ____ mins late will be charged. The occasional unexpected and un-preventable latenes will not be charged. There will be an additinal charge of $_______ per day for school age children attending day care during: holidays, summer,Christmas, spring break,and illness. Parents Parents are welcome to come by ANYTIME during day care hours to check on the child care that is provided. Contract will be reviewed and signed annually. My signature signifies my agreement to the above terms and conditions. As this is a Home Day Care, I feel it is most important that you and I are able to discuss any problems that might come up. I want your child to feel comfortable and happy in our home. We,the undersigned parents of ____________________ hereby give our permission for ___________________ to provide child care services as stated in the above contract. _______________________Date _______________________Day Care Provider ______________________ Parent / Guardian ______________________ Parent / Guardian |
| CHILD'S ENROLLMENT RECORD |
| Child's Full Name:______________________ Date of Admission:______________________ Nickname (if different):________________ Date of Birth:__________________________ Parent's Name:__________________________ Home Phone:_____________________________ Home Address:___________________________ (Mother) Business Information: Name of Business:_______________________ Address of Business:____________________ Office Phone:______________Ext#:________ Alt. Contact #:_________________________ (Father) Business Information: Name of Business:_______________________ Addressof Business:_____________________ Office Phone:______________Ext#:________ Alt. contact #:_________________________ Any Special Instructions on how to reach parents: _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ In case of illness or other emergency, give the name, address, and telephone number of nearest relative or friend who can be contacted if the parent's cannot be reached. _____________________________________________________________________ Give name, address and telephone number of any person other than parent who is authorized to pick the child up from the Child Care Home. _____________________________________________________________________ Child's Pediatrician or source of health care:(Include Name, address, and telephone #) ___________________________________________________________________ |
| INFANT DAILY REPORT |
| Name:___________ Date:___________ Today I was: Happy Sad Moody For Breakfast today I ate:___________________ For Lunch today I ate:_______________________ For Snack today I ate:_______________________ Bottles: Time:________ oz.__________ Time:________ oz.__________ Time:________ oz.__________ Time:________ oz.__________ Diapers: Time:________ O Wet O BM Time:________ O Wet O BM Time:________ O Wet O BM Time:________ O Wet O BM Time:________ O Wet O BM Nap Time _________ to ___________ ____________ to _________ Today I:________________________________________ My last dose of medicine was at:________________ I need these supplies: Diapers___ Wipes_____ Formula______ Baby Food______ Also look at Introduction, for a sample of how to Introduce yourself as a Child Care Provider. |
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| Visitors: 06504 |