Child Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Gender *

Male

Female

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Language

English

Spanish

Other

Parent/Guardian 1 Full Name *

First Name

Last Name

Phone *

(###)

###

####

Parent/Guardian 2 Full Name

First Name

Last Name

Phone

(###)

###

####

Name *

First Name

Last Name

Phone *

(###)

###

####

Authorized to Pick Up Child? *

Yes

No

Desired Start Date *

MM

DD

YYYY

Emergency Medical Treatment *

I give permission for my child to be photographed or recorded during activities, and for these images to be used for school-related purposes such as newsletters, displays, or social media.

Yes

No

Photo & Video Consent *

I give permission for my child to be photographed or recorded during activities, and for these images to be used for school-related purposes such as newsletters, displays, or social media.

Yes

No

Transportation or Field Trip Permission *

I give permission for my child to participate in school-approved field trips and be transported as needed under staff supervision.

Yes

No

Liability Waiver *

I understand that while all reasonable precautions will be taken, Lil Kingdom Warriors Academy is not liable for injuries beyond its control.

Yes

No

Faith-Based Curriculum Acknowledgment *

I understand that Lil Kingdom Warriors Academy incorporates Biblical principles and Christian teachings into its daily curriculum.

Yes

No

Permission to Apply Sunscreen/Bug Spray *

I give permission for staff to apply sunscreen or bug spray to my child as needed.

Yes

No

Potty Training Acknowledgment (for toddlers) *

I understand and support the daycare’s potty training process, and will collaborate with staff if applicable.

Yes

No