Enrollment Form

Highland Forest Daycare and Learning Center

To enroll your child at Highland Forest Daycare and Early Learning Center, you’ll need to fill out an enrollment form.

Child’s Information

Full Name

Date of Birth

Gender

Home Address

Parent/Guardian Information

Primary Parent/Guardian Name

Relationship to Child

Phone Number (Home, Work, Mobile)

Email Address

Secondary Parent/Guardian Name

Relationship to Child

Home Address (if different from child's)

Phone Number (Home, Work, Mobile)

Email Address

Emergency Contacts

Emergency Contact Name #1

Relationship to Child

Phone Number

Emergency Contact Name #2

Relationship to Child

Phone Number

Authorized Pick-Up Persons

Name

Relationship to Child

Phone Number

Medical Information

Child’s Doctor Name

Doctor’s Phone Number

Medical Conditions

Allergies

Medications

Immunization Records (attach a copy)

Enrollment Details

Program Desired

Desired Start Date

Additional Documentation to Attach

*You may also submit required documentations via this form or in person at the Highland Forest Daycare and Early Learning Center.

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Highland Forest Daycare and Learning Center

Enrollment Form

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