THE TREE HOUSE, Inc.
Childcare Center & Preschool
ENROLLMENT FORM
Date enrolled:__________ Date ended:___________
Child’s Name__________________________Birthday_________________
Child’s Name__________________________Birthday_________________
Child’s Name__________________________Birthday_________________
Child’s Name__________________________Birthday_________________
Parent’s Name_________________________Home Phone______________
Home Address_____________________ City_______________ Zip_____________
Employer______________________________________
Work Phone______________________Cell Phone____________________
Work Address____________________ City__________________ Zip___________
Parent’s Name_________________________Home Phone______________
Home Address__________________________ City_____________ Zip__________
Employer________________________________________
Work Phone______________________Cell Phone____________________
Work Address____________________ City__________________ Zip_________
Email Address for invoices/ProCare System:
Parent’s Email _____________________________________
Parent’s Email _____________________________________
Does your Child/Children have any allergies:
________________________________________________________________
________________________________________________________________
________________________________________________________________
Does your Child/Children eat a special diet?
_______________________________________________________________
_______________________________________________________________
Please list foods/beverages your Child cannot have:_____________________
_______________________________________________________________
Does your Child/Children take medicine on a regular basis?
________________________________________________________________
________________________________________________________________
(If yes you may need to fill out a medication form if the medicine is to be taken while in care)
Anything special you would like us to know about your child regarding their care here at the Tree House? (Disabilities, etc.)_______________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Authorized Person’s to pick up when Parent is not available:
Full Name ___________________________________________
Phone Number______________Address____________________
Relationship to Child/Children___________________________
Full Name ___________________________________________
Phone Number______________Address____________________
Relationship to Child/Children___________________________
Full Name ___________________________________________
Phone Number______________Address____________________
Relationship to Child/Children___________________________
PARENT SIGNATURE_________________________DATE____________
For a printer-friendly version, please copy and paste this link into your browser:
https://1drv.ms/w/s!Am8rup-F0vS8gQYQ225of8V0fUq9
Childcare Center & Preschool
ENROLLMENT FORM
Date enrolled:__________ Date ended:___________
Child’s Name__________________________Birthday_________________
Child’s Name__________________________Birthday_________________
Child’s Name__________________________Birthday_________________
Child’s Name__________________________Birthday_________________
Parent’s Name_________________________Home Phone______________
Home Address_____________________ City_______________ Zip_____________
Employer______________________________________
Work Phone______________________Cell Phone____________________
Work Address____________________ City__________________ Zip___________
Parent’s Name_________________________Home Phone______________
Home Address__________________________ City_____________ Zip__________
Employer________________________________________
Work Phone______________________Cell Phone____________________
Work Address____________________ City__________________ Zip_________
Email Address for invoices/ProCare System:
Parent’s Email _____________________________________
Parent’s Email _____________________________________
Does your Child/Children have any allergies:
________________________________________________________________
________________________________________________________________
________________________________________________________________
Does your Child/Children eat a special diet?
_______________________________________________________________
_______________________________________________________________
Please list foods/beverages your Child cannot have:_____________________
_______________________________________________________________
Does your Child/Children take medicine on a regular basis?
________________________________________________________________
________________________________________________________________
(If yes you may need to fill out a medication form if the medicine is to be taken while in care)
Anything special you would like us to know about your child regarding their care here at the Tree House? (Disabilities, etc.)_______________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Authorized Person’s to pick up when Parent is not available:
Full Name ___________________________________________
Phone Number______________Address____________________
Relationship to Child/Children___________________________
Full Name ___________________________________________
Phone Number______________Address____________________
Relationship to Child/Children___________________________
Full Name ___________________________________________
Phone Number______________Address____________________
Relationship to Child/Children___________________________
PARENT SIGNATURE_________________________DATE____________
For a printer-friendly version, please copy and paste this link into your browser:
https://1drv.ms/w/s!Am8rup-F0vS8gQYQ225of8V0fUq9