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Parent / Guardian Information

Full Name

Relationship to Child

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Phone Number

Email Address

Select *

Emergency Contact Information

Emergency Contact #1

Prefix

First Name

Last Name

Relationship to Child

Phone

Emergency Contact 2

First Name

Last Name

Relationship to Child

Phone

Authorized Pickup Contacts

Name

Phone

Name

Phone

TextAnyone not listed here will NOT be allowed to pick up your child

Child Information

First Name *

Middle Name

Last Name *

Date Of Birth *

Month *

Day *

Year *

Select *

Allergies / Dietary Restrictions *

Medical Conditions / Special Needs

Medications (if any)

Primary Care Physician:

Phone

Preferred Hospital (optional)

Enrollment Details

Select *

Desired Start Date *

Select *

Drop Off Time *

Hours

Minutes

AM/PM

Pickup Time *

Hours

Minutes

AM/PM

How Did You Hear About Sweet Bloomers LLC?

Consent & Agreements

Please check all that apply:

SelectFirst Aid & CPR – I authorize Sweet Bloomers LLC staff to administer first aid or CPR as needed.Medication Administration – I authorize staff to administer prescription medications as directed.Emergency Transport – I authorize staff to call 911 and/or transport my child to the nearest hospital in an emergency.Photo / Media Release – I consent to my child being photographed or recorded for educational or promotional purposes unless otherwise noted.Policy Acknowledgment – I have received, read, and agree to abide by the Sweet Bloomers LLC Parent Handbook, including tuition, absences, discipline, and emergency procedures.Child Care Voucher / Copay Acknowledgment – I understand that CCS payments are my responsibility until confirmed by the state.

Date

Optional / Additional Information

Special Interests / Activities for Child

Hobbies / Likes / Dislikes

Anything else staff should know

A Beautiful Place For Small People

Useful links

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Got a question?

Email: contact.sweetbloomers@gmail.com Customer Care: support@sweetbloomers.org
Phone: +12405000425
Monday - Friday
Hours: 8:00am - 6:00pm
Address: 7728 Presidential pkwy Upper Marlboro MD 20774

Home
About us
Contact us
Our Programs
Enrollment