Free printable daycare enrollment form.

Families fill this in to apply or to enroll. Keep it in the child’s file, and ask for updates each year.

Program name (optional)

It prints at the top of the form.

Child enrollment form

Program

Child’s full name

Name the child goes by

Date of birth

Start date wanted

Room or program

Home address

Days wanted:MondayTuesdayWednesdayThursdayFriday

Care wanted:Full dayHalf dayBefore or after school

Parents and guardians
Name	Relationship	Cell phone	Work phone	Email

Emergency contacts who are not parents
Name	Relationship	Phone	May pick up the child

Health

Doctor’s name and phone

Allergies

Medicines

Health conditions or special needs

Languages spoken at home

Anything else we should know

Immunization record attached:YesNot yet

This information is true. I will tell the program when anything changes.

Parent or guardian signature

Date

Free printable form from bloomily.app/tools/forms

How to use this form

Give it to families at the tour, or when they apply.
Check every line before the first day, and ask about any blanks.
Attach the immunization record and any other papers your state asks for.
Keep it in the child’s file, and ask families to update it each year.

Check your state’s rules

Licensing rules set what an enrollment record must hold, such as immunizations and a doctor’s contact. Check your state’s rules, and add what it asks.

Find your state’s licensing page

Do this in Bloomily

In Bloomily, you build your own enrollment forms, and families fill them in online. They can upload files and sign from any device.

See online enrollment

Questions, answered

What goes on a daycare enrollment form?

The child’s details, each parent’s phone and email, the days of care, and health facts. Add emergency contacts and a parent signature.

Is this the same as an application form?

It works as both. Use it when a family applies for a spot, then keep it on file once the child starts.

See it with your name on the door.

Get started

or book a demo

Run more than one kind of program? Talk to us.