We are a licensed center for children 6 weeks- 12 years.

Age Groups:

Infants- 6 weeks-1 year Mobile Infants- 1 year-2 years

Group size 8 2 Teachers Group size 8 2 Teachers

Toddlers-2-3 years Preschool- 3-5

Group size 10 2 Teachers Group size 20 2 Teachers

School Age- 6 years and up

Group size 13 1 Teacher

Child Care Enrollment form and Emergency Consent Form

This form is only for folks who like to enroll now- If you are expecting family please fill out our waitlist form listed under the Contact Us tab. Thank you!

Date

YYYY

Desired Start Date

YYYY

Child's Name

First Name

Last Name

Date of Birth

Parent/Guardian 1 Name

First Name

Last Name

Parent Guardian 1 Phone Number

(###)

###

####

Parent Guardian 1 Work Number

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Parent/Guardian 2

First Name

Last Name

Parent Guardian 2 Phone Number

(###)

###

####

Parent Guardian 2 Work Number

(###)

###

####

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name of Emergency Contact 1

First Name

Last Name

Relationship

Phone # Emergency Contact 1

(###)

###

####

Allowed to pick up Child

Yes

Name of Emergency Contact 2

First Name

Last Name

Relationship

Phone # Emergency Contact 2

(###)

###

####

Allowed to pick up Child

Yes

Name of Emergency Contact 3

First Name

Last Name

Relationship

Phone # Emergency Contact 3

(###)

###

####

Allowed to pick up Child

Yes

Physician's name

First Name

Last Name

Physician's number

(###)

###

####

Dentist Name

First Name

Last Name

Dentist Number

(###)

###

####

Child's Health Insurance Plan

Subscribers Name ( On insurance card)

SPECIAL CONDITIONS,DISABILITIES, ALLERGIES, OR MEDICAL EMERGENCY INFORMATION

PARENT/GUARDIAN CONSENT and AGREEMENT for EMERGENCIES As parent/guardian, I consent to have my child receive first aid by faculty staff and, if necessary, be transported to receive emergency care. I will be responsible for all charges to covered by my insurance. I consent for the emergency contact person listed above to ACT ON MY BEHALF until I am available. I agree to review and update this information whenever a change occurs and at least every 6 months. BY TYPING YOUR NAME YOU ARE AGREEING TO EMERGENCY TREATMENT AND TRANSPORTATION IF NEEDED.

Any other information that would be helpful for us to know about your child?

CONTRACTED HOURS-The earliest time you can schedule to drop-off is 6:30am and the latest time you can schedule to pick up is 6:00pm. BE SPECIFIC AND ENTER TIMES YOUR CHILD WILL BE HERE.Please choose daily time frames that do not exceed the 9 hours a day you are allowed. This helps us plan staffing accordingly. We ask that you strictly adhere to them so we can staff accordingly. Any changes that need to be made you must speak to the Director in advance. Please share any difficulties you may have with adhering to this policy.

Monday

Tuesday

Wednesday

Thursday

Friday

Pjs Childcare Center, St. Albans VT

Pj's Childcare center is an early education program located in St. Albans VT that is licensed to serve children 6 weeks-12 years. For more information please call us at (802)528-5533. You can also find us on FB @PJschildcarecenter

Enrollment Information

We currently are enrolling all ages!

Age Groups:

Pjs Childcare Center, St. Albans VT

Contact Us!

Enrollment