Skip to content
Enter Family Information
Themes :

Little Steps Childcare

Menu

Your Child's Information

      

Allergies

Child's Primary Doctor

Child's Primary Dentist

Health History

Only pdf, doc and docx file formats are allowed.

Operation/Serious Injuries

Current Medications

Physical Limitations

Dietary Limitation

Are there any activities you would prefer your child NOT to participate in?

Photo Permission

Additional Comments/Information

Parent / Guardian Information

Emergency Contacts - Please list 2 that are NOT Parents

Child Pickup Authorization

NOT Authorized For Pickup

Only pdf, doc and docx file formats are allowed.
Back  

Congratulations!

Your Information Has Been Received

To finish your application, you must sign some forms with your finger on a phone or tablet.
Please enter an email address that you can open on your phone.