Joy and angels Nursery Home Policy statement

(Mrs./Mr.)_________________________

Name of Child(ren)______________________________________________
                             ______________________________________________

Fees:    (Hourly)___________________

(Weekly)     $__________

Payment required at the start of the week   $___________

Non-refundable Deposit:         1 week   $__________

Non refundable Registration Fee :   $60

Total payments due at the time of registration   $_______ 

Late Pick-up:    $10 per 15 minutes 

Supervision:    Children will not be left without competent supervision at any time.

Visiting: Parents are free to visit during nursery hours.
             Visitors must sign visitor’s control log.
             Parents must sign their child in and out everyday.

Healthcare policy: Upon enrollment parents will furnish child’s physical and Immunization records.

Clothing: Parents should supply an extra set of clothing, diapers and bedding covers. Please write your child’s name on each item.

Napping Policy:

Nap time: ___________  Crib __________  Cot_________ 

Food Supplied by:  Parent ___________  Nursery (snacks only) 

Contract cancellation  (two  weeks notice). 

*A 30 day trial period will be given to all children, after which we  reserve
the right to dismiss a child if we are unable to meet the child’s need or if the child 
is endangering or threatening to the other children.

Parent’s Signature________________________ Date________________ 

Provider’s Signature ______________________   Date _____________

Joy  and Angels Nursery

84 Nassau Blvd West Hempstead, NY 11552

Ph# 516 -538-5090                                                           

Date__________________

Child’s Full Name______________________________________________________

Mother’s Name________________________________________________________ 

Father’s Name ________________________________________________________ 

Home Address _______________________________________________________________________ 

            ______________________________________________________________________ 

Home Phone#    ______________________________      

1.                    Emergency contact Person and Ph#__________________________________________________________

2.                        Emergency contact person and Ph#__________________________________________________________

Pediatrician’s Name ______________________________________ 

Pediatrician’s Ph# ________________________________________                                     

Names of Responsible Persons who will pick up your Child

Name :                                                 Relationship                        Ph#

1.       ________________________          _____________________                 _____________________

2.       ________________________          _____________________                 _____________________

3.       ________________________          _____________________          _______________________

     Please attach copies of your Child’s physical and immunization records with registration form.