Child Information Packet

Please complete the following form and turn a printed copy into Robins Nest before your child's first day. Do to the sensitivity of some content found in our Child Information Packet, you are required to print this form and fill the remainder out by hand.

Child Info.

Parent / Guardian Info.

Emergency Contact &
Pick Up Authorization

I authorize the following people to pick up my child/children: They must sign in/out after presenting a valid ID when picking up child/children.

Emergency Medical Release

, being the parent or legal guardian of give my consent for emergency medical and surgical treatment of this minor by a licensed physician should his/her condition so require it in my absence. I understand that in such a case reasonable attempts would first be made to contact me, time & condition permitting. As long as the medical or surgical treatment considered necessary in the situation is in accordance with generally accepted standards or medical practice for the particular type of injury or illness involved. I impose no specific limitations or prohibitions regarding treatment other than those that follow:

I also understand children play & do sometimes get hurt by tripping, falling off play equipment & other various activities. I/we will not hold Robin’s Nest responsible for medical attention needed in such a case unless the licensing finds the center negligent.

I do not have Medical Insurance.

I do have Medical Insurance.
Please provide a copy of your card or print out insurance information.

Classroom Info.

Is your child potty trained?

Does your child still have potty accidents?

Can your child write their name?

Best way to communicate?

Feeding Agreement

Health, Safety & Sanitation At Robin’s Nest hand washing is the most important way we keep illness down in our classroom. Please wash your child’s hands when they enter our classrooms. Please do not leave a diaper bag, car seat or anything that could hold medications or other dangerous items in the reach of children in our classrooms, hallway or office. If you need to leave something for someone picking up, there is a place in the gym. Ask the director. Please provide us with a change of clothes in a zip lock bag with your child’s name on it to leave in the bucket. Diapering, Diapers & Wipes Please provide diapers & wipes weekly and log those diapers in daily so you have a record of when you last dropped some off to us. Please be sure your child’s name is on everything you turn in. In the event we do not have diapers for your child, we will provide diapers for $1.00 each and a box of wipes for $5.00. We will diaper your child as an infant every other hour or as needed and every two hours as a toddler.

Yes, I agree with the above policy.

Food Program & Feeding Schedules
Robin’s Nest participates in the state food program. Robin’s Nest provides formula (milk-based/soy Good start) and all bottles, solid food, and cereals. There are no additional fees or requirements from the parents to participate in this program. Robin’s Nest is an extension of your family and will vary from this procedure to fit parents’ needs for their children that meet the basic requirements for care in our facility based on DCFS rules and regulations and that of your physician.

I will be using the center’s food program

I will be bringing my own food & bottles
(See below for requirements)

I am breastfeeding my child

I will provide my own bottles

I will be bring my own food and use the center's bottles

If you want your child fed outside of the food program requirements outlined above, we need you to provide the needed items on a daily basis. 1. We need enough bottles to feed your child every 3 hours or as you have prescribed here in this form and DCFS. a. The bottles need to be labeled with your child’s name on them. Lid, nipple & bottle if we wash them at the center. b. Be filled with formula or formula powder ready to serve. c. Will be sent home daily after we have rinsed them. We will not wash them at the center because we don’t want to mix them up with the hundred bottles/nipples we have here. 2. If you want your child fed with a specific bottle, we will need you to provide 4 bottles prepared as outlined above. 3. We will need a can of the formula you are using to mix for cereal meals as needed. When we have used it, we will send home the empty can so you know we need more. We encourage our parents to check your child’s bucket daily for needed items. We are extremely busy so we may forget to mention it to you. 4. When you drop off bottles daily, please place on the counter in a zip lock bag and we will put in your child’s feeding bucket. 5. When you pick up, we will place all used bottles in the zip lock bag and return to you each evening. Please replace the next day your child will be attending our school. 6. If you forget to bring formula/ food, we will call you and let you know. If we do not have what we need by the time your child needs to eat, we will feed your child what we serve based on the food program. Please let us know in writing as your child’s feedings change as they grow. There is a form in the classroom on the door to change feeding schedules and add new things to your child’s diet. Drop that form in the tuition box and the director will follow up with the infant staff that following week to meet the upcoming changes.

Please update monthly until eating table food. I understand the feeding requirements outlined in this agreement and would like my child to:

Be fed based on the food program that the center offers.

I will provide for my child daily as outline above and understand that if I do not provide the needed food, the center will use their food to meet the needs of my child.

My child is breastfed

I would like my child fed the following times & amounts while in care at Robin’s Nest:

On demand oz:

Other (see details below)

Print Child Enrollment Form

Thank you for completing Robin's Nest's Child Enrollment Form. Please download and print the form below. The form must be turned in before your child's first day at Robins Nest.

Because this form contains sensitive information, we strongly recommend not emailing it to us.