Kid Central CNY School-Age Childcare Registration (V1)

Thank you for your interest in Enrolling in Kid Central CNY's School-Age Childcare Program. We are honored to work together with you and your child(ren).

Program Details:
  • $40/day/child 
  • Advance Pay Discounts
  • Multiple Child Discounts
  • Full-Day Program (Monday-Friday) Openings
  • 7:30a-4:30p
  • Grades 1-6
Includes:
  • WiFi
  • Chromebook Tech Support
  • Custom Coaching for Remote Learners
  • Recreation Breaks
  • Lunch & Snack Breaks (*Lunch, snacks and water bottle must be brought from home)
  • New, Clean, Safe & Secure Building
  • Child Worker Supervision

NOTE: This form will "time-out" if left alone, so have the following information ready before beginning - medical insurance & 2 emergency contacts information.

Please follow the steps below and submit:

Step 1 - Complete all fields in the form below for each child being registered. 

Step 2 - Submit form.

Once registration form is submitted, you will be contacted to set up an appoinment to complete the final registration process. Please check your email for a confirmation email outlining what to bring with you to your appointment.

Looking forward to serving your family at Kid Central CNY!

Program Days Applying For

Tip: Please select all that apply.

General Information

Parent/Guardian Information

Emergency Contact/Authorized Pick-Up Information

In the event of an emergency when I may not be reached, Kid Central CNY staff may contact the following individuals whom I authorize to take my child from the child care premises.

Note: (2) Emergency Contacts are required.

Child's Physician/Insurance Information

*Please provide a copy of your child's current physical prior to his/her first day of preschool.

Tip: Please answer None if applicable.

Medical Insurance Information

Permissions & Authorizations

The below digital signatures shall constitute an original for all purposes set forth. Please write full name.

Emergency Medical Treatment Authorization

I hereby give Kid Central CNY LLC staff members permission to administer basic first aid and/or CPR to my child, as named below, and/or take my child, as named below, to a hospital for medical treatment when I cannot be reached or when delay would be dangerous to my child's health.

Parental Visit Notice

I understand that I may visit the Kid Central CNY Childcare programming unannounced at any time during the hours that my child is in care.

Permission to Administer Over-The-Counter Topical Products

I give permission to Kid Central CNY LCC to apply the topical, over-the-counter products I have checked off below to my below named child, according to the labe and/or package instructions. I agree that a brand name or generic product will be used, unless I have supplied Kid Central CNY LLC with a specific product brand. (All parent-supplied over-the-counter products must be kept in their original packaging and labeled with child's first and last name. Please bring in products that have a printed expiration date on the packaging.)

Tip: Please select all that apply.

Policy Regarding Release of Children

I understand that Kid Central CNY LLC accepts responsibility for my child upon his/her arrival to the program. Kid Central CNY LLC will not be responsible after my child leaves the program as authorized on the enrollment form. Chidren will be allowed to leave the program with persons other than the parent only if written permission has been given to Kid Central CNY staff. I understand that any changes to the arrival/departure arrangements must be made in writing to the Kid Central CNY staff.

Authorization for Photographs and Video Recording

Tip: Please select one option.