Child Registration Form | Little Heavenly Ones

This section creates your child's internal profile for the use of the Director

REGISTRATION

Family Information

Title

Parent's Name 1

Parent/s Email 1

House/Apt Number 1

Parent's Name 2

Parent's Email 2

House/Apt Number 2

Address 1

City 1

State 1

Zip 1

Cell phone 1

Employer 1

Work Phone 1

Address 2

City 2

State 2

Zip 2

Cell phone 2

Employer 2

Work Phone 2

Upload your identification

Select File

Upload your identificaion 2

Select File

Student Information

First Name

Anticipated Start Date

Middle Name

Last Name

Upload a profile pic of your child

Select File

Nick Name

Child's Age

Child's Birthday

Drop-off and Pick up Times *

02:30 PM

Supplemental Income

What is the value of the scholarship?

If you are the recipient of CAPS, please provide the director with a current copy of your scholarship reward letter.

Emergency Contacts

Emergency Contact Name

Emergency Contact Name 2

Medical Center/Doctor

Pediatrician

Emergency Contact Phone

Emergency Contact Phone 2

Pediatrician's Phone

Medication & Special Diet

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STATE REQUIRED DOCUMENTS

This section is required by the state of Georgia for all Quality Rated Child care facilities

Please click the links below, read, e-sign your signature, and submit. You and the Director will receive copies of all completed forms via the emails provided by both parties.

If you have technical difficulty with the e-sign option above. Please download the forms below, complete and return to the director.

Parent Handbook

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Food Program Application

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Liability Insurance

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“Enrichment & care before the classroom”

CALL US: p.404-292-3551

f.404-292-3382

This section creates your child's internal profile for the use of the Director

REGISTRATION

Family Information

Student Information

Supplemental Income

If you are the recipient of CAPS, please provide the director with a current copy of your scholarship reward letter.

Emergency Contacts

Medical Center/Doctor

Medication & Special Diet

STATE REQUIRED DOCUMENTS

This section is required by the state of Georgia for all Quality Rated Child care facilities

Parent Handbook

Food Program Application

Liability Insurance

Parent Handbook

Food Program Application

Liability Insurance