Child Care Application For Admission

Child's Name(Required)

First Last

Preferred Name

Phone Number(Required)

(###) ###-####

Birth Date(Required)

My Child is:(Required)

Male

Female

Home Address(Physical)(Required)

Street Address Apt # City State ZIP Code

I would prefer my child be enrolled in:(Required)

Enrollment Date:

Termination Date:

Enroll my child for:(Required)

Full Time

Part Time

After School Care

Before School Care

Hourly Care

Drop In

Summer Camp

You chose 'Part Time'. Which days do you need?

2 days (Tuesday/Thursday)

3 days (Monday/Wednesday/Friday or whatever is available)

I'm Flexible

Other

Allergies & other medical conditions:(Required)

Plan of action for allergic reactions:(Required)

Parent/Guardian Name:(Required)

First Last

Parent Email:(Required)

Phone:(Required)

(###) ###-####

Home Address(Physical)(Required)

Street Address Apt # City State ZIP Code

Place of work:(Required)

Work Phone:(Required)

(###) ###-####

Parent/Guardian Name:

First Last

Phone:

(###) ###-####

Home Address(Physical)

Street Address Apt # City State ZIP Code

Place of work:

Work Phone

(###) ###-####

Is either Parent Deceased?(Required)

Yes

Parent’s Marital Status:(Required)

Married

Separated

Divorced

Others

Remarried?(Required)

Yes

Custody Arrangements?

Is anyone restricted from seeing or picking up the child? If so, please list.(Required)

In an emergency, contact: (alternative names other than parents/guardians. Must have two)

Name(Required)

Relationship(Required)

Phone Number(Required)

Name(Required)

Relationship(Required)

Phone Number(Required)

Is there any additional information you would like to share about your child? (Favorite things, foods, special interests or fears, etc.?)

Emergency Medical Care Authorization

Consent(Required)

*I hereby give permission for emergency medical treatment for If requested by: Kids Point who is our child care provider.(Required)

Please note that my child is allergic to the following medications:(Required)

It is also important to note that my child has the following special medical conditions:(Required)

Parent Signature:(Required)

First Last

Date:(Required)

MM slash DD slash YYYY

Name

This field is for validation purposes and should be left unchanged.

Drop In & Hourly Care Consent

Please check each box below stating you agree and are aware of the policies.

Hourly Care for Rec Center Members: fill out below section

Consent

I understand that if I need hourly care I need to reach out to Kids Point at 605-641-3367 the night prior to guarantee the spot. Limited spots are available.

Consent

I understand that I can only sign up for 1 to 2 hour slots during the timeframe of 6am-12pm and 2pm-5pm.

Consent

I understand I am charged $8 an hour for the 1-2 hour sign up time frame.

Consent

I understand that if I exceed my sign up time and am late picking up I will be charged $1 every minute I’m late.

Consent

I understand I need to bring personal supplies for my child: diapers, wipes, extra clothes, bottles/food, water bottles.

Consent

I understand If my child is here at 11:30am I need to bring lunch.

Consent

I agree to sign in and out on the brightwheel app and pay my hourly care bill at the end of every month.

Drop In Care: fill out below section

Consent

I understand I need to provide diapers and wipes if applicable, a water bottle, nap supplies,extra clothes, and lunch only on mondays.

Consent

I understand I will be added to our brightwheel app. There I will check my child in and out and also pay my bill electronically on the system.

Consent

I understand I need to reach out 24 hours prior to see if there is a spot available for my child to attend Kids Point the day I need drop in care.

Consent

I consent my child to go on a field trip and be transported the day they are attending if there is a field trip planned for the day. Kids Point uses appropriate car seats and certified drivers.

Parent Signature:

First Last

Parent Email(Required)

Date:(Required)

MM slash DD slash YYYY

Phone

This field is for validation purposes and should be left unchanged.

1 Year Old Consent

Child's Name(Required)

First Last

Consent(Required)

I give consent for my child to have whole milk at Kids Point.(Required)

Wait until this date to start.(Required)

Consent(Required)

I give consent for my child to have peanut butter at Kids Point.(Required)

Wait until this date to start.(Required)

Consent(Required)

I give consent for my child to have honey at Kids Point.(Required)

Wait until this date to start.(Required)

Consent

I would like my child on catered lunches monday-thursday that my child is contracted for at $5 per day.

Consent(Required)

I approve of my child to start on the Kids Point full menu.(Required)

If not, list what items to avoid due to allergies or sensitivities:

Parents Signature:(Required)

First Last

Parent Email(Required)

Date(Required)

MM slash DD slash YYYY

This field is for validation purposes and should be left unchanged.

Child Medication Authorization Form

Child's Name(Required)

First Last

Today's Date(Required)

MM slash DD slash YYYY

Name of medication to be administered(Required)

Dosage(Required)

Time to be given(Required)

Dates to be given: From(Required)

dd/mm/yy

Dates to be given: To(Required)

dd/mm/yy

Parent Signature(Required)

First Last

Parent Email(Required)

Today's Date(Required)

MM slash DD slash YYYY

Please send a message to the teacher on brightwheel that you filled out a medication form online and a medication needs to be given to your child. This way we get it in a timely manner.

Name

This field is for validation purposes and should be left unchanged.

ParentHandbook

Daycare & Preschool Packet

Child Consents

Please initial prior to each policy stating you understand and will abide by them:

Consent(Required)

I have received and read the parent handbook. I agree to the rules and policies addressed in the handbook.(Required)

Consent(Required)

I understand that I must message the teachers on the app with schedule changes as soon as possible so we can evaluate staffing. If it is an extended absence please call or message 605-641-3367(Required)

Consent(Required)

I understand that if the center is closed for a holiday, emergency, or other unforeseen-circumstances that I am still responsible to pay the contracted weekly rate if I want to hold my spot. If you do not want care in the summer, you will need to continue paying to guarantee your spot for the fall.(Required)

Consent(Required)

I understand that payment for Kids Point services is due every Friday and if not paid by Monday at 8AM will receive a $30 late fee. If the bill is not paid in full by 8AM the following Monday an additional $30 late fee is applied and services will be terminated.(Required)

Consent(Required)

I understand there is an annual Registration/Supply Fee. If you terminate care after this you do not get a refund.(Required)

Consent(Required)

I understand that if I am later than the center's closing time. I will be charged $1 for every minute past due. Unless other arrangements are made. Center hours are 5:30am-6:00pm.(Required)

Consent(Required)

I understand that if I need care prior to 6:00 am or my normal scheduled time I need to signup with the director.(Required)

Consent(Required)

I understand that all food provided from Kid Point is free of charge. If for some reason the kitchen is closed you will not be reimbursed because it is just an added luxury.(Required)

Consent(Required)

I understand that if any concerns or changes need to be made that I should call and talk to Kids Point administrators at 605-641-3367. Messages on Brightwheel are not closely monitored by administrators, mostly by main teachers.(Required)

Consent(Required)

I understand that if I choose to leave this center, a two-week notification of discontinuance of care must be given in writing to the Owner/Director. Kids Point bill will continue to accrue for those two weeks following notification. Bill must be paid in full by the last day of care and then your deposit will be returned to you within 30 days of termination.(Required)

Consent(Required)

I understand if my child is in the Preschool class there will be a monthly field trip fee.(Required)

Consent(Required)

I understand that I need to purchase a Rec Center Pool Pass yearly for our field trips. If purchased by April 31 you will get it half off.(Required)

Transportation Permission Form

Consent(Required)

I give permission for Kids Point staff to transport my child in their vehicle for field trips/activities, to and from school, or in an emergency. I am aware that they will have my child in a proper safety harness and will follow the state laws for vehicle safety.(Required)

Photo Consent

I give permission for Kids Point to take pictures of my child throughout the day and post them on the following areas:(Required)

Send to parent on brightwheel app

Post on public facebook page

I don't give permission for Kids Point to take pictures of my child

Child's name(Required)

First Last

Child's Name(Required)

First Last

Parent's Name(Required)

First Last

Email(Required)

Phone(Required)

Date(Required)

MM slash DD slash YYYY

Phone

This field is for validation purposes and should be left unchanged.

Start UpInformation & Supplies

School Age Packet

School Age Consents

Please initial prior to each policy stating you understand and will abide by them:

Consent(Required)

I have received and read the parent handbook. I agree to the rules and policies addressed in the handbook.(Required)

Consent(Required)

I understand that if the center is closed for a holiday, emergency, or other unforeseen-circumstances that I am still responsible to pay the contracted weekly rate if I want to hold myspot. If you do not want summer care you will need to continue paying your school time weekly tuition to guarantee your spot for the following fall.(Required)

Consent(Required)

I understand that the Summer Program has a supply fee of $50.(Required)

Consent(Required)

I understand that if I am later than the center's closing time. I will be charged $1 for every minute past due. Unless other arrangements are made. Center hours are 5:30am-6:00pm.(Required)

Consent(Required)

I understand that if I need care prior to 6:00 am or my normal scheduled time I need to signup with the director.(Required)

Consent(Required)

I understand there will be a Field Trip fee to cover the expenses.(Required)

Consent(Required)

I understand I need to buy my child a Rec Center Pool Pass By April 31 to get it half off.(Required)

Consent(Required)

I understand that if I sign my child up for the Summer Program I am contracted my weekly rate for the whole summer from when school ends, to the start of school.(Required)

Consent(Required)

I understand that if I choose to leave this center a two-week notification of discontinuance of care must be given in writing to the Owner/Director. Kids Point bill will continue to accrue for those two weeks following notification. Bill must be paid in full by the last day of care and then your deposit will be returned to you within 30 days of termination.(Required)

Consent(Required)

I understand if I am in the after-school program and sign up for an additional half or full day there is an additional cost.(Required)

Transportation Permission Form

Consent(Required)

I give permission for Kids Point staff to transport my kid in their vehicle for field trips/activities, to and from school, or in an emergency. I am aware that they will have my child in a proper safety harness and will follow the state laws for vehicle safety.(Required)

Photo Consent

I give permission for Kids Point to take pictures of my child throughout the day and post them on the following areas:(Required)

Send to parent on brightwheel app

Post on public facebook page

I don't give permission for Kids Point to take pictures of my child

Child Name(Required)

First Last

Child's Name(Required)

First Last

Parent's Name(Required)

First Last

Email(Required)

Phone(Required)

Date(Required)

MM slash DD slash YYYY

This field is for validation purposes and should be left unchanged.

Parent Portal

Daycare & Preschool Packet

School Age Packet