Enrollment Instructions

Downloadable Enrollment Instructions

Central Drop-In Child Care Center Enrollment Form

1. Enrollment Form: An Enrollment form is required for each child who will attend the Drop-In Center services. Leaving sections of the Enrollment Form blank will delay enrollment. Complete all sections of the Enrollment Form including:
   • Blue Card ID number is required.
   • Authorized Permission for Emergency Pick Up: Adults who may be contacted in an emergency when the parent/guardian cannot be reached and to with whom the child may be released. Emergency personnel will only release a child to someone on this list in an emergency. Per Connecticut State Law:
     • You must list at least one person who is not the child’s parent/guardian
     • Please give the first and last name of everyone on this list
2. Authorized Permission for Alternate Pick Up: Adults who are authorized to pick up the child. The Drop-In Center staff will only release your child to adults on this list. It is your responsibility to tell the staff at drop- off if there will be an alternate pick up and the name of the adult picking up. Adults authorized to pick up a child should be prepared to show their license at the time of pick up.
3. Complete, sign, & date the following:
   • Emergency Authorization (required)
   • Parent Information Packet & Behavior Management Policy Agreement (required)
   • Permission for Activities away from Premises (optional)
   • Photographic Consent & Release Preference Form: (Selecting a preference is required. Children without authorization will be unable to be photographed during special events).

INCOMPLETE ENROLLMENT FORMS WILL NOT BE ACCEPTED AND WILL DELAY ENROLLMENT, PROGRAM REGISTRATION, AND/OR ABILITY TO MAKE DROP-IN RESERVATIONS

Enrollment Instructions Continued:

Health Assessment Record

1. A current Health Assessment Record is mandatory for enrollment
2. An updated Health Assessment Record is required yearly upon expiration for enrollment status to remain current.
3. Use the checklist below to prepare your HAR.

Health Assessment Record Checklist

• HAR Part 1 – completed, signed, dated by parent/guardian
• HAR Part 2 – completed, signed, dated by physician (date of exam must be within the year and updated every year)
• HAR Immunization – updated immunizations
• Dental section is not required
• If your physician requires emergency medication at school/child care facility, additional paperwork is required.
• CT INFLUENZA VACCINE REQUIREMENTS: Connecticut law requires that children ages 24–59 months receive at least one dose of the flu vaccine each year between August 1 and December 31 to attend school. This includes children who attend licensed child care programs. Children between the ages 36-59 months without documented proof of at least one dose of the flu vaccine within stated timeframe will be unable to attend the Center until after flu season has passed, (after March 31st).

INCOMPLETE/EXPIRED HEALTH ASSESSMENT RECORDS WILL NOT BE ACCEPTED AND WILL DELAY ENROLLMENT, PROGRAM REGISTRATION, AND/OR ABILITY TO MAKE DROP-IN RESERVATIONS.

How To Submit Your Enrollment Documents:

1. All required enrollment documents are sent to: kellymccarthy@ccsu.edu
2. Send all documents as an attachment.
3. The enrollment process can take up to two weeks. Incomplete documents will not be accepted and will delay the enrollment process.
4. When all documents have been received and approved, an email will be sent to your university email with instructions on next steps.
5. Drop-In reservations and/or registration for programs are not allowed until all required enrollments steps have been completed and notification of approved enrollment status has been sent. There are no exceptions to this policy.