Free Daycare Application Form

Please fill out the following information to complete your application.
Child Information
Name
Date of Birth
Gender
Male
Female
Address
Parent/Guardian Information
Name
Relationship to Child
Phone number
Employer
Authorized Pickup Persons
Name
Relationship to Child
Phone number
Health Information
Pediatrician's Name
Phone number
Known Allergies
Medical Conditions
Medications Taken Regularly
Agreement and Signature
I certify that the information provided is accurate to the best of my knowledge and agree to follow the daycare’s policies and procedures as outlined in the Parent Handbook. I understand that this application does not guarantee enrollment, and that a spot will only be confirmed upon further communication from the daycare.
Date:
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Simplify the enrollment process for families and daycare providers with our customizable Daycare Application Form Template. Designed for convenience, this template enables you to efficiently capture essential details about each child. Edit seamlessly with our AI Editor Tool, making it easy to tailor the form to your daycare’s specific needs—ensuring a smooth and professional application process.