Infant and Toddler Enrollment Forms

All About Me:(Required)

(Child's First Name or Nickname)

Child's Name:(Required)

Birthdate:(Required)

Parent/Guardian:(Required)

Cell Phone:(Required)

Work Phone:(Required)

Address:(Required)

Zip Code:(Required)

THINGS MY CHILD DOES WELL:(Required)

WHAT MY CHILD LIKES AND DISLIKES:(Required)

THINGS I AM WORKING ON WITH MY CHILD:(Required)

MY CHILD ENJOYS THESE PHYSICIAL ACTIVITIES:(Required)

MY CHILD HAS DIFFICULTY WITH THESE ACTIVITIES:(Required)

MY CHILD WILL NEED THE FOLLOWING EQUIPMENT AND/OR ROUTINES:(Required)

THINGS MY CHILD MIGHT NEED HELP WITH:(Required)

Parent Handbook Confirmation

Signature of Parent(Required)

Date(Required)

Food and Milk Waiver

Child's Full Name:(Required)

Date of Birth:(Required)

Below is a list of food we regularly serve during snack times. Foods my child CANNOT have that is on the foods list (Please check any food(s) your child may not have due to allergies.)(Required)

Please note any food concerns or known allergies:

My child cannot drink cow's milk, I will supply this as an alternative: (no nut milks, please)(Required)

Guardian/Parent Name:(Required)

Guardian/Parent Signature:(Required)

Today's Date:(Required)

Infant/Toddler Feeding Schedule and Activity Plan

Child's Full Name:(Required)

Date of Birth:(Required)

Feeding:

Check type(s) of liquid you currently offer your child:(Required)

Breast Milk

Milk

Formula

Juice

Water

How much/how often:(Required)

How do you give the bottle, room temp, warmed or cold?(Required)

Does your child hold his/her own bottle?(Required)

Yes

Do you offer cereal with formula?(Required)

Yes

How much/how often:

Check how your child usually eats:(Required)

Spoon-fed

Uses Fingers

Self-spooned

Other

If other, please explain:

Does your child have difficulty eating?(Required)

Yes

Other

(Spits up, chokes easily, allergies)

If other, please explain:

Any reactions to foods introduced?(Required)

Child's usual dining habits (check all that apply)(Required)

high chair

booster seat

feeds self

bottle

uses utensils

lidded cup

regular cup

Please comment on any other information about your child's food history that would be helpful:

Sleeping:

What time does your child usually nap?(Required)

For how long?(Required)

How does your child like to fall asleep/nap?(Required)

(we must nap/sleep infants on their backs unless we have a doctor's note on file to use restrictive device: wedge, roll, strap, etc)

Does your child have a regular sleep schedule?(Required)

Yes

What time does your child usually go to bed at night?(Required)

Does your child sleep through the night?(Required)

If not, how often do they wake?(Required)

What do you do when they wake?(Required)

(feed, rock, change, etc)

Does your child use a pacifier?(Required)

If so, when?

Does your child have a special comfort item to sleep with?(Required)

If so, what is it?

When does your child wake in the morning?(Required)

Please comment on any other information about your child's sleeping habits that would be helpful:

Activities:

What type of activities does your child like?(Required)

What type of activities does your child dislike?(Required)

What makes your child feel better when they are upset?(Required)

Please comment on any other information about your child's activities that would be helpful:

Parent/Guardian Signature:(Required)

Today's Date:(Required)

Initials/Date: (Every 3 months)

Infant/Toddler Permission Information Form

Please read and initial or sign each section below as indicated. Thank you for your cooperation!

Child's Full Name:(Required)

Date of Birth:(Required)

Please initial each line:

Infant/Toddler Cot Permission Form(Required)

Infant/Toddler Cot Permission Form

I give permission for my child to sleep on a cot during rest/nap time. I will provide a regular size crib sheet and a small blanket for my child.

Diaper or topical cream/ointment (parent provided)(Required)

I give the staff of Frederick Country Day permission to use the following cream/ointment on my child for diaper rash. I have used this product previously without any adverse reaction to my child's skin. I will provide and label it with my child's name. I will be responsible for refills as needed.(Required)

Your Name:(Required)

Guardian/Parent Signature:(Required)

Today's Date:(Required)

Occasionally, the children take 20-30 minute Discovery Walks through the Dearbought community. The children are encouraged to discover sights, sounds and scents for classroom discussion. Please choose yes or no below to give your child permission to participate.(Required)

YES, my child may participate in the Discovery Walks

NO, my child may not participate in the Discovery Walks*
*In this case, your child would remain in the office until his/her class returns.

The children of Frederick Country Day participate in an inter-generational program with the residents of Heartfields, an assisted living community for the elderly. Heartfields is located on Wheyfield Drive, next door to Frederick Country Day. The children may walk to Heartfields to visit with the residents on special occaisions. Please choose yes or no below to give permission for your child to participate in this beneficial program.(Required)

YES, my child may visit Heartfields Assisted Living Center.

NO, my child may not visit Heartfields Assisted Living Center*
*In this case, your child would remain in the office until his/her class returns.

Occasionally, we may take pictures of special school events to be printed in the local newspaper. Please choose yes or no below to give permision for your child's picture to be taken and printed.(Required)

YES, my child's picture may be taken and printed in the local newspaper.

NO, my child's picture may not be taken and printed in the local newspaper.

Frederick Country Day, www.frederickcountryday.com, seeks permission to include individual/group photos for this website. (No names used). Please choose yes or no below to give permission for your child's picture to be included.(Required)

YES, my child's photo may be included in Frederick Country Day's website.

NO, my child's photo may not be included in Frederick Country Day's website.

Frederick Country Day posts pictures and videos of in-school activities, field trips, and special events on social media (Facebook, Instagram, etc.) Please choose yes or no below to give permission for your child's picture to be posted.(Required)

YES, my child's photo may be included on Frederick Country Day's social media accounts.

NO, my child's photo may not be included on Frederick Country Day's social media accounts.

Your Name:(Required)

Parent/Guardian Signature:(Required)

Today's Date:(Required)

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Infant and Toddler Enrollment Forms

Parent Handbook Confirmation

Food and Milk Waiver

Infant/Toddler Feeding Schedule and Activity Plan

Infant/Toddler Permission Information Form

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