Child Care Agreement

Please complete this Child Care Agreement form before your child beginds learning and care at A Child's Heart. We try to make the application process as painless as possible. You will complete this one form, which encompasses a total of four essential documents (Intake, Medical History, Immunization, and Consent) during the application process. This form allows us to have a general knowledge of your child's background, an in-depth overview of your child(ren)'s medical history (so we can provide your child with the proper care), allows us to provide care to your child in the case of a medical emergency, and informs us of the of the times and days your child(ren) will attend A Child's Heart.  For your convenience, we offer two ways you can complete this form-- either electronically or by downloading the PDF and printing it out.  

By completing the form below, A Child's Heart will be able to provide the best possible care and learning environment for your child. 

Download and Print

 

Child Care Agreement Form

 

If you have any questions, please feel free to Contact Us!

 

Childcare Agreement Form

*Note: All fields marked with an asterisk (*) are required.