ENROLL NOW

Enrollment Forms

To enroll in Jabbers Kids Daycare, please fill out the following forms.
A nonrefundable enrollment fee of $100 for Full Time care or $50 for Part Time care is due upon receipt of this form.
There is NO FEE to enroll in FlexCare.

Vaccination records or waiver is required to complete enrollment. Please email copies to jabberskids@gmail.com or request vaccination waiver to be signed (upon drop-off) in form.

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Type of Care Your Enrolling In(Required)

Full Time (3 – 5 days per week) – $100 holding fee due upon completion of this form

Part Time (1 -2 days per week) – $50 holding fee due upon completion of this form

Flexible Care – No holding fee

ICCP (requires approval prior to enrollment)

PERSONAL DETAILS AND DESCRIPTION

Child's First Name:(Required)

Child's Last Name:(Required)

Date of Birth:(Required)

Child Age

Gender:(Required)

Male

Female

ICCP:

Yes

Military Assistance:

Yes

Sibling Attending?(Required)

Yes

Yes, more than 1 additional

For sibling enrollment, after receiving enrollment approval email, sign into account on jabberskids.com and select “Sibling Enrollment” for each additional siblings.

Sibling name(s) and age(s):

DAYS PLANNING TO ATTEND (Full or Part time)

Desired Date of Admission:(Required)

Monday

Tuesday

Wednesday

Thursday

Friday

If using planning to use Flexible scheduling: average days a week

Home Address:(Required)

City:(Required)

Zip:(Required)

PARENT/GUARDIAN INFO – Both will receive a text invite to download our Brightwheel App for secure pick up and drop off

Primary Parent/Guardian:(Required)

First Last

Relation:(Required)

Email Address:(Required)

Phone #:(Required)

Home Address (if different from child):

This person will be primarily or sometimes…

Marital Status(Required)

If “separated” or “divorced” please provide any court ordered custody documentation if applicable.

Custody Status(Required)

In order to comply with legal and safety standards, we must follow court-ordered custody arrangements as written in official documentation.

Second Parent/Guardian:

Relation:

Email Address:

Phone #:

Home Address (if different):

This person will be primarily or sometimes…

Vaccination records(Required)

I have uploaded my records below

I will email copies to jabberskids@gmail.com

Please provide a vaccination waiver with drop off

Immunization Records

Drop files here or

Max. file size: 4 MB.

You may also sign a waiver in person at the first drop off if your child is not immunized.

CHILD LANGUAGE INFO

Please keep in mind that our primary care givers use English in the classroom, however, several teachers do speak Spanish as well. Please reach out to management if you have any language concerns or requests.

Child's Primary Language(Required)

Secondary Language (optional)

Does your child have speech difficulties or delayed speech?

Yes

if so, please explain:

HEALTH

Physical Conditions / Disabilities(Required)

Yes

If Yes, please list(Required)

Any Regular Medications(Required)

Yes

Please notify admin if there if staff needs to administer medication.

If Yes, please list(Required)

Does your child have allergies?

Yes

If so, please list items and reaction:

For any allergies that are life threatening or may cause an emergency situation, please notify administration.

EATING HABITS

Describe your child's eating habits

Favorite Foods

Foods Refused

Anything you do not want us giving your child (i.e sugar, juice, chips)

What does your child eat with

Spoon

Fork

Hands

How many full meals does your child eat per day?

TOILET HABITS

Is your child currently in diapers?(Required)

Yes

Pull Ups – potty training

Note: If needed, please make sure to provide diapers and wipes upon your first drop off

Regarding the potty, does your child…

Not potty trained

Need frequent reminders

Need help wiping

Fully potty trained, asking to use the potty when needed

Other

Select all that apply

How often does your child use the toilet?(Required)

How many bowel movements per day

*Are Bowel movements regular?

Yes

*Any concerns about diarrhea?

Yes

*Any concerns about constipation?

Yes

Is your child ever reluctant to use the bathroom?

Yes

How does your child indicate bathroom needs (include special words):

What is used at home?

Potty Chair

Special Child Seat

Regular Seat

Does your child have accidents?(Required)

Yes

Additional concerns/comments:

SOCIAL RELATIONSHIPS

How would you describe your child's personality?(Required)

Previous experience with childcare(Required)

Reaction to strangers

Able to play alone?

Favorite toys & activities

Fears (dark / animals etc.)

Behavior Management method at home

How do you want us to comfort your child?

SLEEPING HABITS

Does your child have a time of the day they they get tired or need down/quiet time?

Does your child have a fussy time?

Does your child nap during the day at home?(Required)

If yes, what time and how long?

Does your child use a pacifier?(Required)

Yes

Only for nap time

Describe any special characteristics or sleeping needs (stuffed animal, story, mood on waking, etc.):

PLEASE NOTE

Jabbers Kids does not have a forced nap time, however, we take a 30 minute “quiet time” on sleeping cots. Children who are able to nap are given the space to do so and children who do not fall asleep are taken to the main Jabbers floor for play time or guided through a quiet activity in the room.

Emergency Contact/Authorized

EMERGENCY CONTACT/AUTHORIZED PICK-UP PERSON

If there’s an emergency situation where I cannot be reached, the Educator is authorized to contact the following individuals (in the listed order) to collect my child from the child care facility. The following are authorized to pick up my child. This person will receive a text inviting them to our Brightwheel App.

1 – ONE

Full Name:(Required)

Telephone #:(Required)

Relation:

This person will be primarily or sometimes…(Required)

In the Brightwheel app, I would like this person to be able to…(Required)

View my child’s activity, messages, receive/send messages

Only Perform Pick-up & Drop-off

Have no app access, but serve as an additional contact for staff in emergency situations

2 – TWO

Full Name:

Telephone #:

Relation:

This person will be primarily or sometimes…(Required)

In the Brightwheel app, I would like this person to be able to…(Required)

View my child’s activity, messages, receive/send messages

Only Perform Pick-up & Drop-off

Have no app access, but serve as an additional contact for staff in emergency situations

3 – THREE

Full Name:

Telephone #:

Relation:

This person will be primarily or sometimes…(Required)

In the Brightwheel app, I would like this person to be able to…(Required)

View my child’s activity, messages, receive/send messages

Only Perform Pick-up & Drop-off

Have no app access, but serve as an additional contact for staff in emergency situations

4 – FOUR

Full Name:

Telephone #:

Relation:

This person will be primarily or sometimes…(Required)

In the Brightwheel app, I would like this person to be able to…(Required)

View my child’s activity, messages, receive/send messages

Only Perform Pick-up & Drop-off

Have no app access, but serve as an additional contact for staff in emergency situations

PARENT CONSENT(Required)

I agree to the privacy policy.

I, the undersigned, hereby consent to enroll my child at Jabbers Kids Daycare. I authorize Jabbers Kids Daycare and its staff to provide care, guidance, and supervision for my child while attending the daycare. I understand that the daycare staff will take all necessary precautions to ensure my child’s safety and well-being.

PHOTO RELEASE(Required)

I agree to the photo consent.

My child may appear in group photos/videos shared privately with families via the Brightwheel app. These images are not for personal social media sharing. Jabbers Kids Daycare may also use photos/videos for marketing and will make reasonable efforts to avoid identifying children (i.e not showing their face).

PARENT HANDBOOK(Required)

I agree to the policies in the handbook

View the Parent Handbook

Signature

Alternative Signature (Type Name)

If you have issues signing the field above. Enter your name to serve as your signature.

PAYMENT AND LOGIN INFO

Total

Coupon

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Expiration Date Month Year

Security Code Cardholder Name

Create a username and password which can be used to schedule flexible care here on our website.

Email:(Required)

Password(Required)

Enter Password Confirm Password