Daycare Child Arrival Check-in
Please complete this form to check in your child for the day. Accurate information helps us ensure your child's safety and well-being.
Child's Full Name
*
First Name
Last Name
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Arrival Date and Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Person Dropping Off the Child
*
First Name
Last Name
List of Authorized Pick-Up Persons (Please provide full names)
*
Does the child exhibit any of the following symptoms today?
*
Fever
Cough
Shortness of breath
Sore throat
None of the above
Other
Temperature at Arrival (°F or °C)
*
Allergies or Special Instructions (if any)
Signature of Parent/Guardian
*
Check In
Check In
Should be Empty: