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Child Care Registration Form Template

Effortlessly Simplify Your Child Care Enrollment Process

Struggling to keep track of child care registrations? This Child Care Registration Form template is designed to help day care providers and parents streamline the enrollment process, ensuring a smooth experience for everyone involved. Benefit from easy data collection, reduced administrative work, effective communication between parents and staff, and a professional appearance that instills confidence in your services. With this customizable, WCAG-aligned template, you can quickly gather essential information and get started with enrollment-explore the live template now.

Child full name
Child date of birth
If you selected Prefer to self-describe, please specify (optional)
Home address
Child gender
Woman
Man
Non-binary
Prefer to self-describe
Prefer not to say
Primary parent/guardian full name
Primary email
Primary phone
Authorized pick-up persons (other than guardians): list names, relationships, and phone numbers
Relationship to child
Mother
Father
Legal guardian
Step-parent
Grandparent
Other
Please Specify:
Program type
Infant care (0-12 months)
Toddler care (1-3 years)
Preschool (3-5 years)
Pre-K
After-school
Summer program
Not sure yet
Other
Please Specify:
Requested start date
Attendance days
Monday
Tuesday
Wednesday
Thursday
Friday
Varies week to week
Need extended care (early drop-off/late pick-up)?
Yes
No
Emergency contact 1 full name
Emergency contact 1 phone
Primary care physician name
Physician phone
Allergies or dietary restrictions (if any)
Medical or developmental considerations we should be aware of (if any)
Are immunizations up to date?
Yes
No
Permission to administer basic first aid if needed
Yes
No
Permission to administer over-the-counter medication per center policy
Yes
No
Photo/video consent for program use (non-commercial)
Yes
No
Parent/guardian signature
Date signed
I have read and agree to the center policies and parent handbook
Strongly disagree
Disagree
Neither
Agree
Strongly agree
Special instructions or notes
How did you hear about us?
Friend or family referral
Current or past family referral
Online search
Social media
Community event
Flyer or signage
Pediatrician/Agency
Other
Please Specify:
{"name":"Child full name", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Child full name, Child date of birth, If you selected Prefer to self-describe, please specify (optional)","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}
Paper art illustration featuring a colorful child care registration form with creative design elements

When to use this form

For centers, preschools, and home providers, use this form when you enroll a new family, update records each semester, or move a child from waitlist to a confirmed spot. It collects guardian details, emergency contacts, medical info, schedule, consents, and policies in one place, so you can staff rooms, align ratios, and meet licensing rules. If you manage interest lists first, pair it with the Childcare center pre-registration form to qualify families before you request full details. Once enrolled, connect this form to your Daycare attendance form to track daily sign-in and absences. Programs that include older siblings can also reference the After school care sign out sheet form to streamline pickups.

Must Ask Child Care Registration Questions

  1. Who are the legal guardians and who is authorized for pickup?

    This confirms custody and release rights, reducing risk at drop-off and pickup. Listing names, relationships, and photo ID details prevents confusion and protects every child and staff member.

  2. Does your child have allergies, medical conditions, or medications?

    Health details guide safe meals, activity choices, and emergency care plans. Clear instructions help staff respond quickly and avoid triggers.

  3. Who are two emergency contacts outside the household, and what are your preferred hospital and physician?

    Backup contacts ensure we can reach someone fast if guardians are unavailable. Hospital and doctor information speeds decisions and keeps care aligned with your wishes.

  4. Which days and hours do you need care, and what is the planned start date?

    Your schedule helps set ratios, staffing, and room placement. If you track arrival and departure later, the Attendance form keeps time records consistent.

  5. Which program and classroom are you applying for (infant, toddler, preschool, or after care)?

    Program selection aligns age, curriculum, and space, so your child lands in the right setting from day one. Families moving into pre-K can review the Preschool registration form to keep requirements in sync.

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