ENROLLMENT

Join Our Family Today

REGISTRATION

Join Our Family Today

We’re excited to welcome your family to Inspiring Minds Childcare! Enrolling in our programs is easy and marks the first step in your child’s journey of discovery, growth, and joyful learning. If you have any questions about the form or the enrollment process, don’t hesitate to reach out to us.
We’re happy to help!

1

Complete our enrollment form by filling out your information below.

2

Submit the enrollment form and it will be sent direct to our team.

3

Once we’ve reviewed your form, our team will reach out to guide you through the next steps.

Child Care Registration and Emergency Information

This form must be completed for each of your children who will be enrolled in the program and must be updated whenever information changes.

This field is for validation purposes and should be left unchanged.

Program Information

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Child Information

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Child's Address(Required)

Parent / Guardian 1

Identifying information of parent(s) or guardian(s) legally responsible for child.
Parent / Guardian 1 Home Address(Required)
Indicate where this parent/guardian can be reached while the child is in care.
Parent / Guardian 1 Business Address(Required)
Include any special instructions, e.g. pager, cell phone, etc.

Parent / Guardian 2

If applicable, provide identifying information for a second parent or guardian legally responsible for the child.
Parent / Guardian 2 Home Address
Indicate where this parent/guardian can be reached while the child is in care.
Parent / Guardian 2 Business Address

Emergency Contact Persons

You (parent/guardian) are required to list at least 1 person with whom you would feel comfortable leaving your child, and who could assume responsibility for your child if you could not be reached immediately in an emergency, or if for some reason you could not pick up your child and were unable to communicate with the program. Examples: if your child were sick and you were not accessible, or if you experienced sudden illness between work and picking up your child.
Emergency Contact 1 Address(Required)
Emergency Contact 2 Address

Non-Emergency Alternate Pick-Up Person(s)

I, as parent/guardian, authorize the following individual(s) to pick up my child from the program on a non-emergency basis.
Alternate Pick-Up Person 1 Address(Required)
Alternate Pick-Up Person 2 Address

Child Care Licensing — Permission to Speak with Child

The licensing authority for this program is the Bureau of Licensing and Certification, Child Care Licensing Unit. During visits to programs, licensing staff may speak with children regarding the care they receive. Licensing staff are experienced in working with children and trained to speak with them in a respectful and non-leading manner. Children will remain with their class or group during these conversations, and at no time will a child be forced to speak with a licensing coordinator.
Permission for Licensing Staff to Speak with Child in Group(Required)
Please indicate whether licensing staff may speak with your child while they are with their class or group.
Permission for Licensing Staff to Interview Child Separately(Required)
If licensing staff believes your child may have specific information regarding an alleged event at the child care program, and determines that it is best to interview your child separately and not with their class or group, please indicate your preference.

Medical Information

Please list any chronic conditions, allergies, or medications that could be important in case of sudden illness or injury. Enter "None" if not applicable.
Physician's Address(Required)

Emergency Medical Treatment Authorization

I hereby give permission for the staff of this child care program to provide simple first aid treatment to my child when necessary. In the event of a more serious illness or injury, I give permission for my child to be transported to a hospital or other emergency medical facility to receive emergency medical treatment. I also authorize ambulance/rescue squad attendants to administer such treatment as is medically necessary, and I authorize licensed health practitioners working in the hospital or emergency medical facility to examine and provide emergency medical treatment to my child if warranted. I understand that I will be contacted by child care program personnel as soon as possible regarding any emergency involving my child.
Parent / Guardian Signature(Required)
Clear Signature
By signing below, you agree to the Emergency Medical Treatment Authorization above.
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Our Philosophy

WHY CHOOSE US?

At Inspiring Minds Childcare, were more than just childcare—we're a community dedicated to your child's growth and happiness. Our Reggio Emilia-inspired approach nurtures curiosity, creativity, and confidence in a safe, supportive, and engaging environment.

With experienced educators, individualized attention, and thoughtfully designed spaces, your child will thrive in every stage of development.

Get in Touch

WE’D LOVE TO HEAR FROM YOU!

At Inspiring Minds Childcare, we’re here to answer any questions you may have. Whether you’re interested in learning more about our programs, scheduling a tour, or have inquiries about enrollment, our team is ready to assist you.

Feel free to reach out to us using the contact form below, by phone, or by email. We’ll be happy to provide you with all the information you need to make the best decision for your child’s care and education.

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