2011/2012 Registration Packet Directions and Tuition Schedule

Print, complete and return the forms noted below to the Child Care Programs Office. 9625 Warner Ave., Fountain Valley, CA 92708
Phone 714-962-4099
A confirmation will be emailed to you by the Child Care Programs Office after payment and additional forms have been received.

• Contract - sign in blue ink
• Enrollment Form - 2 pages
• 2 Emergency Cards - print two!
• ID and Emergency Information - LIC 700
• Child's Preadmission Health History - Parent's Report - LIC 702
• Physician's Report - LIC 701 (return before start date)
• Consent for Emergency Medical Treatment - LIC 627
• Personal Rights - LIC - 613A (return bottom portion only)
• Parent's Rights - LIC 995 (return bottom portion only)

You will fill out the following forms at the Child Care Programs Office in order to receive a confirmation:

• School Health Record - parent section only
• Immunization Record - fill out top section only