FLHS Child Care Enrollment Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in the FLHS Child Care Class.

Please read this section before filling out the form. This form is only one piece of your enrollment. You must complete all steps for your enrollment to be considered complete.

Upon completing this form, please mail Ms. Bell at jbell@fairlawnschools.org including the following documents as attachments:

Copy of your child's Birth Certificate
Copy of Proof of Residency. This can be your driver's license that shows a Fair Lawn address, a lease agreement, a PSEG bill to your home

In addition to these items, the tuition check or money order made out to "FL Board of Education" must be mailed or dropped off to:

FLHS Child Care

Attn: Ms. Bell

14-00 Berdan Ave

Fair Lawn, NJ 07410

Medical Forms can be found HERE or on the Child Care Webpage and must be filled out by your child's doctor and emailed to Ms. Bell by September 1, 2024

Email *

Child's Full Name *

Does your child have a nickname they would like to be called? *

Home Address: *

Mother's Name and Cell Phone: *

Father's Name and Cell Phone: *

Child's Birthday: *

YYYY

Does your child speak English fluently? *

If your child doesn't speak English, which language do they speak fluently?

Is another language spoken in the home, even if your child can speak English?, If so, what language? *

What religion does your family observe? *

Are there any other children living in your home? If so, what are their names and ages? *

Does your child have any FOOD allergies? If so, what are they? *

Does your child have any other non-food allergies? If so, what are they? *

Does your child have any special dietary needs? If so, please explain. *

Does your family have any special circumstances that I should be aware of? If so, please explain. *

Can your child use the bathroom independently? *

Yes

Does your child need any special modifications in the classroom? If so, please explain. *

Please briefly describe your child. Feel free to tell me about his/her personality, academic abilities, what they enjoy playing with, how they get along with peers etc. *

Emergency Contact #1:

Name, phone number, and relation to the child

Emergency Contact #2:

Name, phone number, and relation to the child

Child Pick Up Permission:

Who is allowed to pick up your child from class? (up to 3 people other than a parent)

List the name, phone number, and relation to the child

Photo Consent:

I allow my child to be photographed in the classroom. I understand that these photos will not be posted or published on any personal social media. These will be used for classroom purposes like bulletin boards or crafts. If the district social media or website would like to use your child's photo, you will be asked for special permission.

Yes

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Fair Lawn School District. Report Abuse

Forms