Application – LULLABIES AND LAUGHTER DAY CARE CENTER

Date / Time

FEES: Please note that fees for registration, uniform, books, or tuition are non-refundable.

Registration fee: $200.00 inclusive of Registration & seat fees, (1) P.E. Kit, (1) Uniform Set and Insurance. Ask about our time packages: We are currently open from 7:00 am to 5:30 pm Mondays- Fridays.

STUDENT INFORMATION SECTION:

CHILD’S NAME *
First
Middle
Last

DATE OF BIRTH *

CURRENT AGE *
Student must be e.g. 2 on or before September 30th, to enter appropriate grade level

GENDER *
Male
Female

NAME OF LAST SCHOOL ATTENDED

LEVEL

Reason for leaving:

PARENTS’ INFORMATION SECTION (FATHER)

FATHER’S FULL NAME *
First
Last

DATE OF BIRTH *

CURRENT ADDRESS
Address Line 1
Address Line 2
City
State / Province / Region

PLACE OF EMPLOYMENT

ADDRESS OF ESTABLISHMENT

WORK PHONE NUMBER

CELL PHONE NUMBER

EMAIL ADDRESS *

MOTHER INFORMATION SECTION

MOTHER’S NAME *
First
Last

DATE OF BIRTH

Address
Address Line 1
Address Line 2
City
State / Province / Region

PLACE OF EMPLOYMENT

JOB TITLE

ADDRESS OF ESTABLISHMENT

PHONE CONTACT

CELLPHONE NUMBER

ALTERNATE NUMBER

INFORMATION SECTIONS

Please select the correct answer.

Family Status *

Student Lives with *

Does the Student or family attend Church?

Does the family have Medical Insurance Coverage?

If yes, what company?
Medical Card must be presented for coverage waived

CHILD’S MEDICAL SECTION / CONFIDENTIAL INFORMATION

You will be provided with a Medical Form from our Centre, which you will take to a doctor of your choice. Once a certified physician has filled out the application (preferably not a family member), please return the form to your child’s homeroom teacher for safekeeping.

Does your child suffer from any allergies? Whether to food, peanuts, or medicine? *
Yes
No

Please explain

Please provide any medication given to the child regularly

Reason

Types of food

Insect bites
Yes or No

Pollens

Animals

Medication

(please note that medications are never purchased nor administered by our school on your behalf.)

Are there any concerns regarding social, emotional, or behavioral issues you may like to share about your child?

Additional information about any “yes” answers you would like to share?

Is your child's immunization current?
If No please state why

Name of Child’s Doctor

Business Address
Address Line 1
Address Line 2
City
State / Province / Region

Business Telephone

Please indicate by select any communicable diseases the child may have/had in the past
Measles
Mumps
Chicken Pox
Other

Please indicate if there are any health or Physical Disabilities that the child may have that may interfere with normal performance in classes or outdoors

(I/We), Mr. / Mrs. *

Give Lullabies and Laughter’s Day Care Center Ltd., and Staff permission to obtain medical records regarding my child/ren if the need arises to complete their files. Additionally, should the need arise (I/we) give permission, to administer the following for minor cuts or bruises which may be obtained while playing during the day:

Band-Aid/bandages (Latex Allergy:) *

Antibiotic Ointment (Neosporin, etc.) *

Wound Cleaners (alcohol/peroxide) *

Is the student currently taking medications? *
If yes, please provide medication information to the school office (the reason for the medication, etc). Be sure to update this information anytime a new medication is introduced or an existing medication has been discontinued.

PARENT ACKNOWLEDGEMENT

I,_________________________ and ___________________the, (Parents/Father/Mother/Guardian), of ________________________authorize the following adults listed below, to pick-up (my/our) child during the end of each day as instructed by (me/us). Further, I confirm that the people listed below are at least sixteen years of age or above. As a result of this, (I/we) give Lullabies and Laughter Day Care Center the right to deny any person who appears to be too young below the age of sixteen (unless (I, we) send our instructions via a telephone call or WhatsApp message to release (my/our) child to an under the age of fourteen-year-old who must be accompanied by an adult), intoxicated, or appears to cause danger to my child the authority to deny collection on (my/our) behalf. Additionally, I hereby give Lullabies and Laughter’s Day Care Center the right to deny visitation to anyone listed below; if my child is resting, eating, or involved in class activity, visitation will be denied during that time to a family or friend unless they are collecting my child for earlier than scheduled pick-up for that day. Below, (I/we) have listed their names, numbers, and relationship to (my/our) child(ren) along with their addresses which may be used as one of the school’s security questions which may be asked upon arrival if our family or friend and the school are not able to reach (me/us). I further authorize that LLDCC may reject allowing my child to leave with anyone that is not listed below and I understand that any additional fees incurred as per the Parent Handbook we will be responsible to pay *
Agreed

1. NAME *
First
Last

RELATIONSHIP TO CHILD *

PHONE *

ADDRESS *

2. NAME *
First
Last

RELATIONSHIP TO CHILD

PHONE

ADDRESS

3. NAME *
First
Last

RELATIONSHIP TO CHILD

PHONE

ADDRESS

4. NAME

RELATIONSHIP TO CHILD

PHONE

ADDRESS

Consequently, I agree that if any person(s) of my family or my associates are found using libelous dialogues on social media, the parking lot, or anywhere else, obscene language, or any verbal or physical abuse towards the Administration or Staff at Lullabies and Laughter’s Day Care Centre is grounds for immediate dismissal of my child from LLDCC and legal actions may be taken with no refund of any payments made in full to the school. *
Agreed

FINANCIAL OBLIGATIONS BY PARENT OR GUARDIAN

I further agree that I, (Mr./ Mrs./Ms.), ________________________,(is/are) fully responsible for the tuition or any other payments that the school requires at each scheduled time it is due. I understand that it is (my/our) obligation(s) to ensure that the fees are paid whether my child attends school or not. I further understand that the fees paid each week or each month are firstly non-refundable or non-transferable to another week, month, or child. Secondly, I also understand that the fees paid are also to reserve my child’s NAME RELATIONSHIP TO CHILD PHONE NUMBER ADDRESS 5 space as well as my Financial Contractual Agreement (FCA) with the school Lullabies and Laughter Day Care Center d/b/a LLDCC. I understand that fees paid in advance will not be waived or transferred due to vacation in the active school’s term, illness, absenteeism, withdrawal, or for any other reasons. Lastly, (I, we) the Parent(s)/ Guardians of ____________________________ further agree, should there be any medical emergencies, (I /we) give full authorization to Lullabies and Laughter’s Day Care Center, to call the ambulance or carry my child/ren) to the nearest Government Clinic, Princess Margret Hospital, or Doctor’s hospital (please circle one) for emergency care, while making efforts to contact, (us/me), the parent(s) if to no avail; as the (parent/ guardian) of _______________________________ I fully acknowledge that it is (my/our) sole responsibility(ies) to pay for any medical bills, transport fees or added fees for bills which may incurred in this ordeal and the school is not to be held liable for any expenses therein. *
Agreed

PARENT PERMISSION

Upon your child's enrolment, we will occasionally post photos on our website, flyers, or on our social media pages. This keeps our parents and guests updated with events and constructive activities that our Centre offers for educational purposes only. By signing below, you are giving your permission for our school to photograph your child and take your child off campus to engage in safe, fun activities with or without written notice given to you before departure. This form gives us the rights and permission to override any future documents that may not be signed by you for your child to participate in events on or off campus should written permission be obtained. Further, you are relinquishing any rights towards receiving monetary compensation from LLDCC for any accidental events and advertisements, and so on. Moreover, you are also permitting your child(ren) to participate in our field trips and any educational events with photos and videos being displayed on the television or our social media accounts. Lastly, thank you for considering our Centre for providing a firm foundation for your child’s educational journey in the future. We look forward to working closely with you and your child(ren) and know that you and your child(ren) (is/are) now a part of our school’s family. I Mr. & Mrs.__________________________/Ms._______________________________, have read this application form in its entity, and I have asked questions and received answers to clarify any concerns or doubts therein. Below, I have signed and dated this application form on behalf of my child to attend Lullabies and Laughter Day Care Center to complete his/her early childhood education. *
Agreed

Name *
First
Last

Date / Time *
Date
Time

Signature

Name