Enrollment
Enrollment Application Packet
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Enrollment Application Packet
Enrolling Parent/Guardian Information
Full Name
(Required)
First
Middle
Last
Home Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Primary Phone
(Required)
Secondary Phone
Tertiary Phone
Mobile Carrier
(Required)
Email
(Required)
Employer
(Required)
Work Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Child Information
Child Information
Full Name
Sex
Date of Birth
Date of Enrollment
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Authorizations
Authorization For Emergency Medical and First Aid
I hereby authorize the staff and Director, representing Quality Care Child Development Center Inc. to give consent and all necessary emergency medial and First Aid case for my child(ren) while my child(ren) is in Quality Care Child Development Center Inc.'s custody.
Photography Permission
I give permission for my child(ren) to be included in Quality Care Development Center Inc. photography for publicity purposes.
Field Trip Transportation Consent
I give permission for my child(ren) to be transported by Quality Care Child Development Center Inc. on any and all field trips taken by the center.
Transportation Consent to and/or from School
I give permission for my child(ren) to ride the Quality Care Child Development Center's van or bus to/from school.
Name of Child(ren) & their Elementary School
(Required)
First Name
Last Name
Elementary School
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Does your child(ren) need to be delivered to or picked up from school?
(Required)
Delivered to school
Picked up from school
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What time does your child(ren) need to be delivered to school?
(Required)
Hours
:
Minutes
AM
PM
AM/PM
What time does your child(ren) need to be picked up from school?
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Child(ren) Name
(Required)
First Name
Last Name
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Remove
Parent/Guardian Signature
(Required)
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Date
MM slash DD slash YYYY
Financial Agreement
This is an agreement between the child's parent/guardian and Quality Care CDC. Quality Care CDC agrees to provide a class position in the center for each or your children enrolled in the center. The initial rate of tuition will be outlined below. Both parties understand that the tuition being charged may be changed as the child/children change, classes or as tuition is adjusted with a prior 30 day notice.
Financial Agreements & Terms of the Agreements
(Required)
I acknowledge that I have read and understand each of the financial agreements.
1) All tuition is due regardless of attendance. This includes closing for holidays and inclement weather. All children not in attendance for one week with tuition unpaid will be considered dropped from enrollment and will be replaced with someone from the waiting list. Any child withdrawn for less than 30 days and wishes to re-enroll will be charged a $100.00 enrollment fee per child. If your child has a birthday and it now qualifies you for a lower tuition rate. The tuition rate will be adjusted for the week after the week after your child’s birthday.
2) Activity fees are charged in addition to the weekly tuition during the summer months, as well as spring break, Christmas break and inter-session for year-round schools. Activity fees range from $5.00 - $20.00 which are due at the beginning of each month.
3) In addition to the above, it is agreed that the weekly charges are due, and will be paid in advance. The weekly charges are due on or before 6:00 p.m. Monday of each week. Co-payments for DHS Subsidy are due on or before the 1st day of each month. A late charge of $25.00 Per Day will be charged for payment received after this time. Any family who has not paid by Tuesday for private pay parents and the 3rd day of the month for DHS Subsidy families will be dropped from enrollment unless prior approval has been granted by the director.
4) A late pick-up fee of $2.00 per minute per child for child not picked up by the 10 hour child care maximum. The appropriate charge will be added to the parents/guardians account and due immediately. Our center closes at 6pm if you pick your child up after 6pm you will be charged $2.00 per minute per child.
5) Quality Care CDC charges a $30.00 fee for all returned checks.
6) Quality Care CDC requires two week notice prior to withdrawing a child from the center. If a child is withdrawn without notice, the final two weeks payment will still be due. If payment is not made the parents/guardians will be turned over to a collection agency for payment.
7) At 30 months if your child is not toilet trained there will be an additional $30.00 per month fee. Due on the 1st day of the month. Children are never punished or forced when toilet training. AT 36 months if your child is not toilet trained there will be an additional $30.00 per week toilet training fee. Due every Monday by 6pm.
8) If you withdraw your children from Quality Care CDC Inc. and have an unpaid balance Quality Care CDC Inc. will seek legal action for the remaining balance on the account.
Enrolled Child(ren)
(Required)
Name
Class
Initial Tuition
Discount
Weekly Tuition
Add
Remove
A one time enrollment fee of $30.00 will be charged for the first child and a $15.00 fee for each additional child.
Parent/Guardian Name
(Required)
First
Last
Parent/Guardian Signature
(Required)
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Date
MM slash DD slash YYYY
Parent Handbook
Please read and check the parent handbook highlighted items below stating you have read and understood the guideless of the center.
Breakfast is over at 8:00 a.m. If your child(ren) comes in after 8am, you will need to provide breakfast to your child(ren) before they enter the center. Please do not sit your child(ren) in the lobby with breakfast and leave the center.
(Required)
I agree.
No admittance after 9:15 a.m.
(Required)
I agree.
No outside food or drinks permitted. Please have your child(ren) finish before entering the center.
(Required)
I agree.
No outside toys permitted in the center unless requested by the teacher.
(Required)
I agree.
The parent/guardian will call and notify the center if they are going to pick up their school age child(ren) from school and also notify the school via a note with their child(ren).
(Required)
I agree.
The parent agrees to update the center with any changes regarding their home address, home phone, place of employment, work phone and mobile phone number.
(Required)
I agree.
Diapers and wipes will be provided by the parent. If the teacher has informed the parent on two occasions to bring diapers or wipes and the parent has not brought them the parent will be contacted at work to bring them. If the parent is unable to provide them the parent will be charged $5.00 for a package of wipes and $1.00 per diaper that the center had to provide your child(ren).
(Required)
I agree.
Medication will be given only at 8 a.m., 12 noon, and 4 p.m. Parents are asked to adjust their doses given at home to correspond with these times.
(Required)
I agree.
Infants are able to have a thin blanket not a thick blanket per Oklahoma State Regulations thick blankets can be unsafe for infants.
(Required)
I agree.
If your child(ren) has a van behavior report two or more times within a 60 day period your child(ren)'s transportation privileges will be suspended for two days and the parent will be responsible for transporting the child(ren) to and from school for those two days. Quality Care CDC takes safety very seriously and will enforce this guideline.
(Required)
I agree.
The parent/guardian will call the center and notify the center if your child(ren) is going to be absent.
(Required)
I agree.
All children enrolled in the AM program must be picked up by 6 p.m. regardless of the time they were dropped off this supersedes the 10 hour maximum child care rule.
(Required)
I agree.
Quality Care CDC Inc. has an outside classroom policy and all children attend outside play. Please make sure you dress your child accordingly. Children under the age of 2 years old are not permitted to wear sandals due to safety issues.
(Required)
I agree.
It is our policy that any staff member of Quality Care Child Development Center Inc. is not allowed under any circumstances to provide childcare/baby sit for any parent whose child(ren) attends this facility.
(Required)
I agree.
Parent/Guardian Signature
(Required)
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By signing, I acknowledge that I have received a copy of the Quality Care CDC Parent Handbook. I have read the entire Quality Care CDC parent handbook and agree to all the terms and conditions included in the handbook.
Attention Parents
We have a number of school age and pre school (4 & 5 year olds) children that are destroying the property of the daycare and destroying the facility itself by peeling at the paint, picking at the carpet, and other various things. Fighting is also unacceptable and your child will be suspended for fighting. We are asking that all parents discuss with their child(ren) about destroying property. Going forward, if your child is caught destroying the property or the facility of Quality Care CDC Inc, they will be suspended from the center for 2 full business days and the parents of the child will be financially responsible for the damage that their child caused. During the suspension, you will be responsible for finding alternate child care for your child(ren).
Parent/Guardian Signature
(Required)
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Date
MM slash DD slash YYYY
Feeding Schedule
All foods are served to your child unless we receive a physician’s note stating that your child is allergic or unable to eat a particular item. Vegetables, Fruits, cereal and juice are provided by Quality Care Child Development Center Inc. Parents have to provide formula only.
Child(ren) Information
(Required)
Child First Name
Child Last Name
Child Current Age
Feeding Time Schedule
Feeding Amount
Add
Remove
Infant Feeding Policy
I acknowledge infants are not served table food until they are a minimum of 11 ½ months old
Special Feeding Instructions
Parent/Guardian Signature
(Required)
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Date
MM slash DD slash YYYY
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