Menu
About Us
Virtual Tour
Classrooms
Infant
Toddler
Preschool
Parent Tools
Forms
Contact Us
Bill Pay
Enrollment Form
If you prefer, a
print application is available here
.
Child's Name
Today's Date
Birthdate
Age
Gender
Male
Female
Start Date
Days Attending
Monday
Tuesday
Wednesday
Thursday
Friday
Hours Attending
Child Resides With
Both Parents
Mother
Father
Other
Home Address
Phone
Mother's Name
Mother's Employer
Mother's Employer Phone
Ext
Father's Name
Father's Employer
Father's Employer Phone
Ext
Siblings Ages
Any Special Health Concerns?
Any medication taken regularly?
Any diagnosed allergies?
Takes Bottle
Naps
Potty Trained
Yes
No
Can your child communicate needs easily?
Yes
No
Has your child attended day care before?
Yes
No
Do you use babysitters?
Yes
No
Please list any interests or favorite toys
How Did You Hear About Us?
Why did you choose our center?
Signature
Date
Processing...
Amherst Baby &
Child Care Center
4350 Millersport Hwy,
Buffalo, NY 14228
(716) 688-2068
Mon-Fri:
7am - 6pm
Enroll a child
Forms
Contact Us
Powered by Fission
Content Management System
|
Website Design
by 360 PSG
Please ensure Javascript is enabled for purposes of
website accessibility