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FORMS & DOCUMENTS 

Several of these forms are an essential part of your child's enrollment at KKCC.  Below you will find a few forms that may require additional time to complete prior to entering our program.  We ask parents to please have these available at time of registration to speed up your enrollment process.  Incomplete forms will prevent your child from entering our program.  Additional forms will provided at time of registration to complete your child's enrollment packet.  The enrollment packet is due on Wednesday before your child's first day at KKCC. 

 

Completion of these forms, do not guarantee enrollment or a slot in our program. 

See the Admissions & Tuition page for enrollment information. 

 

 

HEALTH INVENTORY FORM

Part 1 of this form should be completed by parents.  Part 2 of this form may require a physical examination by a physician or certified nurse practitioner.  With this form you must attach a printed record of immunizations by your child's physician or the form labeled Immunization Certification Form (DHMH 896).  Also attach evidence of blood-lead testing, the form labeled Blood-lead Testing Certificate Form (DHMH 4620).  Please have your physician's office stamp and sign the forms.

IMMUNIZATION CERTIFICATION

This form must be completed by a physician or certified nurse practitioner and brought in with the Health Inventory Form (OCC 1215)

BLOOD-LEAD TESTING CERTIFICATE

This form must be completed by a physician or certified nurse practitioner and brought in with the Health Inventory Form (OCC 1215). 

MEDICATION ADMINISTRATION

This form must be completed fully in order for child care providers and staff to administer any required prescription medication.  A new form must be completed at the beginning of each 12 month period for each medication and each time there is a change in dosage or change in time to administer medication. 

EMERGENCY FORM

This form is used to contact parents in case of an emergency.  It is important that you also list family members or friends that can be contacted in case we are unable to reach parents.  Also on the back of the form please note any allergies, medical conditions, or medication your child may be taking.

ALL ABOUT ME

This form was designed to help us get to know your child and to assist us in providing a safe, stable, and healthy environment where your child will feel comfortable in.  Please provide as much information as possible regarding your child as well as any special adaptation that we might need to make to meet your child needs.  

TUITION EXPRESS APPLICATION

With this form, you authorize KKCC to initiate debit entries from your checking or saving account to pay tuition and or fees.  Please note that a Void check must be presented with this form.  The check should have your name and address printed as proof of account ownership.  If a check is not available for this account you must provide us with a letter from your bank to state the following: account owner(s), account status (active), account number, and routing number.  The letter must be printed on bank letterhead and signed by a bank representative.  Online payments are not available.       

GUIDE TO CHILD CARE

This brochure provides information about requirements that that a State-regulated family child care home or child care center must meet.  It also gives parents an understanding of their rights and responsibilities as the parent of a child in regulated care. 

CREAMS AND OINTMENTS

This form is to be used for non-medicated sunscreen, lip balm, Vaseline, lotions, creams, ointments, etc. that are to be applied to external areas only.  These non-medicated ointments must have already been applied previously at home with no adverse effects to the child (i.e. rash, irritation, or other reaction).  A separate form must be completed per over-the-counter topical, sunscreen, or bug repellent spray. 

TUITION DUE DATES

The dates given indicate the day that you are responsible to have funds available for the ACH deduction from the checking or savings account.  These dates do not indicate the actual date of the ACH draft. 

CALENDAR

Here you will find any important dates to take note of, as well as any dates the center is closed.

SUPPLY LIST

This provides a list of personal and classroom supplies needed on your child's first day. 

WITHDRAWAL NOTIFICATION

This form must be completed should you need to withdraw from our program.  Withdrawals require a four-week written notice, with the week beginning on a Monday.

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