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3 Year Old Room
Please fill out this form before arriving at the center. Please include your current email address below.
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Email
*
Your email
Your Name and Child's Name
*
Your answer
What is the best contact phone number for today?
Your answer
Time Expected for Drop off
*
Time
:
AM
PM
Have you given your child any medication in the past 24 hours?
No
Yes
Clear selection
If you answered yes, please list the medication, the time given and the reason for the medication.
Your answer
Did you send anything in your child's bag his/her teachers should be aware of?
Your answer
Is there anything more we should know to provide the best care for your child today?
Your answer
Planned time to pick up
*
Time
:
AM
PM
Person Picking Up
*
Mom
Dad
Other
If you click other, Please type the name of your pick up person. (Make sure they have a photo ID )
Your answer
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