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Little Stars Home Daycare

Thank you for your interest in our home daycare. Please fill out this form to provide us with the essential information about your child and your care needs. This will help us determine if we have a spot available that meets your requirements.

Once we receive your information, we will reach out to discuss availability, answer any questions you may have, and schedule a visit if desired.

We look forward to the opportunity to care for your child!

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Parent/Guardian's Name
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Child's Full Name

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Child's Age

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  Preferred Start Date for Care  

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Does your child have any allergies, dietary restrictions, or medical conditions?

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Please list any allergies (e.g., food, environmental), dietary restrictions (e.g., vegetarian, gluten-free), or medical conditions (e.g., asthma, diabetes) that we should be aware of in order to provide the best care for your child. If none, please type "No".
Parent Phone Number
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Parent Email Address
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