Title Page
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Child Name
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Conducted on (Date and Time)
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Prepared by
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Location
Child Information
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Child Name
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Date of birth
Parents / Guardians
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Parent / Guardian's Name
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Contact Number
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Address
Pick Up/ Drop Off Schedule
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Choose Schedule
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
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Arrival time
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Pick up time
Payment
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Mode of Payment
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Amount
Other Comments
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Other comments
Sign-off
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By signing below, the parent agrees to enter their child into daycare under the terms and agreement.
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Parent's Full Name and Signature
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Teacher's Full Name and Signature