Enrollment - LITTLE TREASURES

Little Treasures Enrollment Form
Student Information
Child's Name

First NameLast Name
Date of Birth
Age
Gender
Child's Name

First NameLast Name
Date of Birth
Age
Gender
Child's Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 1's Name

First NameLast Name
Parent 1's Phone Number

Area CodePhone Number
Parent 1's Email
example@example.com
Parent 2's Name

First NameLast Name
Parent 2's Phone Number

Area CodePhone Number
Parent 2's Email
example@example.com
Parent 1's Home Address, if different from student

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 2's Home Address, if different from student

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Expected Care Hours For Child
Monday, Tuesday, Wednesday, Thursday, Friday

Healthcare Provider
Physician's name
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Hospital Preferred
Allergies
I give permission to Little Treasures Learning Center, Licensed by the State of Michigan to secure emergency medical and/or emergency treatment for the above named minor child while in care.
Signature of Parent/Guardian
Emergency Contacts

Please list names, addresses, and phone number of contacts if parents can’t be reached.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Release Child To:
Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship
Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship
Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship
Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship

Tuition Agreement Contract
Date you would like child to begin attending school:

MonthDayYear
Date
On the date below, Little Treasures Early Childhood Center agrees to provide child care services for the following named child(ren):
Date

MonthDayYear
Date
Name

First NameLast Name
Date of Birth
Name

First NameLast Name
Date of Birth
Enrollment Fee

50.00 Annual Enrollment Fee (Due the first month of enrollment)/$20.00 for Summer
My Child’s scheduled days are:
Weekly Amount Paid
Payments will be made:

WeeklyMonthly
I have received the Little Treasures Early ChildhoodCenter Parent Handbook. Type name below.
Thank you for selecting Little Treasures to be your childcare provider! We are excited for a fun year ahead. In order to provide a safe, quality learning experience and plan for needed resources and teachers for the children at Little Treasures; Payment is expected regardless of absence. Payment obligations are based on the days that you agree to use Little Treasures, not on actual attendance to ensure a spot for your child. Payments may be paid by check, cash, credit card, money order, Cash App, on the website, through the invoice sent to your email or with PayPal.

I understand:

• Payments must be made on Friday, prior to the start of the upcoming week or monthly on the first school day of the month, if paid monthly.

• If my child attends part time and will be absent, they may make up a day on a future date of parent’s choice.

• If I do not bring my child on their scheduled days, my weekly tuition amount will still be the same.

• I must call or message Little Treasures if my child will be absent.

• Payment will be due weekly or monthly based upon agreed tuition amount regardless of absence, school closings or holiday breaks.

• There will be no reduction/adjustment in tuition for sickness, holidays, school closings, student absences, vacations, or snow days.

• Little Treasures will sometimes close for inclement weather. Please have alternate care in case of a snow day.

• I must give a written notice of two weeks to begin the withdrawal period

• If I do not show respect to staff and students, my child may be withdrawn immediately and the contract will be terminated. Payment will still be due for the two-week withdrawal period.

After 2 weeks of non-attendance/non-payment, your child may be withdrawn from Little Treasures if you have not spoken with Stephanie Medina.
Parent Signature

Licensing Rules Disclosure Form

2018-2019
Parents and Guardians:

Little Treasures Early Childhood Center is required to inform you that Pursuant to rule

146 (i) (III) of the Licensing Rules for Child Care Center for the State of Michigan:

(i) The licensing notebook contains all of the inspections, investigation reports and

corrective action plans.

(ii) The licensing notebook is available to all parents during regular business hours.

(iii) Licensing inspection and special investigation reports from at least the past 2 years

are available on the child care licensing website at www.michigan.gov/michildcare

If at any time you would like to see this notebook it is available during regular business

hours.

Please sign below to show that you have received this information for the 2018-2019

school year:
Parent Signature:
Date

MonthDayYear
Date
Discipline Policy Form
Teachers at Little Treasures will utilize positive methods of discipline, so that each child is provided with a safe and nurturing learning environment. Students will learn to develop self-control and how to take responsibility for their own actions. Expectations will be clear and consistent. Kicking, spitting, hitting, disrespectful verbal behavior and other behaviors that will put your child or another child in danger are not permitted. Age appropriate behavior will be modeled and taught. Logical consequences and a calm tone will be used for discipline. Students will discuss their emotions and feelings in order to solve the behavior issue and may be redirected to a new activity. We know that conflicts will arise. We will work with children to solve their problems and create a positive learning situation. Children will learn conflict resolution skills and will be respected.

If a certain behavior (excessive or aggressive) continues to become harmful to others, a parent meeting will be held to come up with a plan to resolve the concern privately. Parents will be provided with a behavior notice. If necessary, families will be connected with community resources for support.

·       If families are unable to follow the rules and agreements set by Little Treasures, the child will be withdrawn. If families and students are unable to speak/treat staff members with respect, their contract will be terminated immediately and payment will still be due for the withdrawal period of two weeks after withdrawal date/notice. Based on the severity or danger of the situation, Little Treasures reserves the right to immediately exclude a child from the program permanently.

·       If needed, a behavior plan will be implemented.

·       If efforts to correct inappropriate behavior are unsuccessful, your child may be suspended from care for a specific amount of time.

·       At the time of the third behavior notice, a short-term suspension of 1-3 days will be issued.

·       The fourth write up will result in a 4-10 day suspension.

·       The fifth write up will result in expulsion from Little Treasures.

Parents have the right to expect that their children will have proper supervision. A child who consistently needs the attention of the staff is taking away the rights and learning experiences of the other children and not allowing the needs of all children to be met.
Child'sName

First NameLast Name
Additional techniques to be used with my child:
I certify that I have received and understand the discipline policy. Type name below.
Date

MonthDayYear
Date
Planned Food Service Program Policy
Meals are eaten family style with staff sitting with the children. Children will bring food from home for lunch. You may provide a snack from home or we will have snacks available. Please see monthly snack calendar. If your child has any allergies please notify us and provide a doctor's note that states the allergy name and reaction that can occur.
I certify that I have received and understand the food service policy. Type name below.
Photo/Video Release Form
Picture/Video Release FormLittle Treasures would like to take pictures and videos of the students throughout the day. These pictures will be used to show learning activities. The pictures will be used to send to parents, in newsletters, and on our website for school purposes.

I give permission to Little Treasures to take and use pictures/videos of my child. I release Little Treasures from any claims arising out of the use of pictures/videos that my child may have.I do not give Little Treasures my permission to take and use pictures/videos of my child.
Parent/Guardian Signature
Should be Empty:

Little Treasures Enrollment Form

Student Information

Expected Care Hours For Child

Healthcare Provider

Emergency Contacts

Release Child To:

Tuition Agreement Contract

Licensing Rules Disclosure Form

Discipline Policy Form

Planned Food Service Program Policy

Photo/Video Release Form