Child Enrollment / Inscripción

Momas Happy Place Daycare · Licensed Group Family Day Care · Lindenhurst, NY

1 Account 2 Child 3 Parent 4 Emergency 5 Care Plan 6 Documents 7 Agreement
1

Create Your Account / Crea tu Cuenta

You'll use this to log in and check your child's status anytime.
Usarás esto para acceder y ver el estado de tu hijo/a.

2

Child Information / Información del Niño/a

Medical and personal details help us provide the best care possible.
Los datos médicos y personales nos ayudan a brindar el mejor cuidado posible.

3

Parent / Guardian Information / Información del Padre, Madre o Tutor

4

Emergency Contacts / Contactos de Emergencia

Who should we call if we can't reach you? / ¿A quién llamamos si no podemos localizarte?

5

Care Plan / Plan de Cuidado

Select the schedule that works best for your family. / Selecciona el horario que mejor se adapte a tu familia.

6

Documents / Documentos (optional)

Immunization records, child's photo for our files, medical forms, etc.
Récord de vacunas, foto del niño/a para nuestros archivos, formularios médicos, etc.

7

Enrollment Agreement & Digital Signature

Please read the agreement below carefully before signing. / Lee el acuerdo a continuación antes de firmar.

MOMAS HAPPY PLACE DAYCARE — ENROLLMENT AGREEMENT

This Enrollment Agreement ("Agreement") is entered into between Momas Happy Place Daycare, a licensed Group Family Day Care located at 8 E. Merritt St., Lindenhurst, NY 11757 (the "Provider"), and the parent or legal guardian completing this form ("Parent/Guardian").

1. CARE & SUPERVISION

Momas Happy Place Daycare is committed to providing a safe, nurturing, and educational environment for all enrolled children. Our facility is licensed by the New York State Office of Children and Family Services (OCFS) and operates in full compliance with applicable state regulations. All staff are CPR and First Aid certified.

2. HOURS OF OPERATION

The daycare operates Monday through Friday, 7:00 AM to 6:00 PM. Late pickup beyond 6:00 PM may result in a late fee. The daycare is closed on major U.S. federal holidays. Any changes to operating hours will be communicated in advance.

3. HEALTH & ILLNESS POLICY

For the safety of all children, a child exhibiting signs of illness (fever of 100°F or higher, vomiting, diarrhea, unidentified rash, or conjunctivitis) may not attend. Parents must arrange prompt pickup if a child becomes ill during the day. Children must be symptom-free for 24 hours before returning after an illness.

4. MEDICAL EMERGENCIES

In the event of a medical emergency, the Provider will attempt to contact the Parent/Guardian and listed emergency contacts immediately. If neither can be reached, the Provider is authorized to call emergency services (911). By signing this Agreement, Parent/Guardian authorizes emergency medical treatment if necessary.

5. AUTHORIZED PICKUP

Children will only be released to individuals listed as authorized for pickup. Valid government-issued photo ID may be required. The Provider reserves the right to refuse release if there is any concern for the child's safety.

6. MEDICATION ADMINISTRATION

The Provider will administer prescription medications only with written authorization from the Parent/Guardian and with the original pharmacy label. Over-the-counter medications require written parental consent with specific dosage instructions.

7. BEHAVIOR & DISCIPLINE

Momas Happy Place Daycare uses positive guidance and redirection techniques. Physical discipline is never used. In cases of persistent disruptive behavior, the Provider will communicate with the Parent/Guardian to develop a plan. The Provider reserves the right to terminate enrollment if the safety of other children is at risk.

8. PHOTO & MEDIA CONSENT

Unless otherwise indicated in Section 6 of this form, the Provider may photograph or record children for use in daycare newsletters, the official website, and social media channels. No images will be sold to third parties.

9. CONFIDENTIALITY

All information provided in this enrollment form will be kept strictly confidential and used solely for the purpose of providing childcare services. Records are maintained securely and in compliance with applicable privacy laws.

10. TERMINATION OF ENROLLMENT

Either party may terminate this Agreement with two (2) weeks written notice. The Provider may terminate enrollment immediately if the safety or well-being of any child is at risk, or if the terms of this Agreement are violated.

11. LIMITATION OF LIABILITY

The Provider carries appropriate liability insurance. The Provider is not responsible for personal belongings, toys, or clothing brought to the facility. Parents are encouraged to label all items. The Provider is not liable for injuries resulting from a child's own actions or from circumstances beyond the Provider's reasonable control.

ACUERDO DE INSCRIPCIÓN — RESUMEN EN ESPAÑOL

Al firmar este formulario, el padre, madre o tutor confirma que:

  • Ha leído y acepta los términos de este acuerdo de inscripción en Momas Happy Place Daycare.
  • Autoriza atención médica de emergencia si no se puede contactar a los padres/tutores.
  • Acepta la política de salud, incluyendo que el niño/a no asistirá cuando esté enfermo/a.
  • Solo las personas autorizadas en este formulario podrán recoger al niño/a.
  • Cualquiera de las partes puede terminar este acuerdo con 2 semanas de aviso previo.
  • Toda la información proporcionada es correcta y completa.

Para preguntas sobre este acuerdo, comuníquese con nosotros al (631) 800-3894 o info@momashappyplace.com.

⬇ Please scroll down to read the full agreement / Por favor desplázate para leer el acuerdo completo

Digital Signature / Firma Digital

Type your full legal name below to sign this agreement electronically. This constitutes a legally binding electronic signature under applicable law.
Escribe tu nombre legal completo a continuación para firmar electrónicamente. Esto constituye una firma electrónica legalmente vinculante.

Your signature will appear here / Tu firma aparecerá aquí

Signed on / Firmado el: October 19, 2026

By submitting you confirm your electronic signature above. / Al enviar, confirmas tu firma electrónica arriba.

Already have an account? / ¿Ya tienes cuenta? Log in / Iniciar sesión