Enrollment, Emergency & Release Information

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Mother's Day Out at South Garland Baptist Church

Child's First and Last Name *

Date of Birth

Birth Month *

Birth Date *

Birth Year *

Address

Address *

City *

Zip Code *

Parent / Guardian / Caregiver

Primary Guardian/Caregiver Full Name *

Primary Relationship *

Primary Cell Phone Number *

Primary Email Address *

Primary Occupation *

Primary Church Affiliation *

Secondary Guardian/Caregiver Full Name *

Secondary Relationship *

Secondary Cell Phone Number *

Secondary Email Address *

Secondary Occupation *

Additional Authorized to Pick Up with Photo ID *

First Additional Relationship *

First Additional Cell Phone Number *

2nd Additional Authorized to Pick Up with Photo ID

2nd Additional Relationship

2nd Additional Cell Phone Number

NOT Allowed to Pick Up Child

Custody papers must be on file with MDO

May NOT Pick Up Child

Medical & Other Important Info

Medical Conditions, Allergies, Alerts, etc. *

List ALL allergies your child may have (including milk, animals, plants, etc.), along with ALL medical conditions and alerts.

Does your child have any physical activity limitations? *

Does your child require any daily medications? *

Workers are not allowed to dispense any medications.

Please give any additional information about your child that you feel would be helpful.

Your Agreement with MDO

For Children and Families

The goal of MDO is to provide activities to meet the physical, mental, social, emotional and spiritual needs of children ages 9 months to 4 years old. We want the children to experience God's love through happy and loving relationships in a Christian environment.
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Monthly Tuition and Registration/Supply Fees

Monthly tuition is $185 for one child. Monthly tuition for two or more children is $175 per child.

The Registration/Supply Fee is $120 annually and is due by August 15 of the new term. This fee is non-refundable after the term begins.

Enrollees are responsible for their Monthly tuition fee, whether or not each day is attended. You are paying for your child's reserved space, not your child's attendance.

Drop-Ins are available by appointment only and all enrollment paperwork must be filled out.
Drop-In Fee: $35.00/day
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Withdrawal

Please notify the Director in writing or email two weeks prior to withdrawal from MDO. There will not be a reimbursement given for partial months attended.
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Schedule

MDO is open on Wednesdays and Fridays 9:00 AM to 2:00 PM during the school year. Children must be picked up promptly at 2:00 pm. A late fee of $1.00 per minute may be assessed if your child is not picked up on time.
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Arrival and Dismissal

The entrance to the Family Ministry Center will be unlocked at 9:00 am. For safety precautions, the doors will be locked from 9:15 am until 1:45. If you arrive during this time, please ring the doorbell to the left of the FMC doors.

A teacher will meet your child at the classroom door. For the welfare of all the children, please wait at the classroom door. Please do not linger at the door. If your child is upset, let the teacher take your child from you. It is easier for your child and the rest of the class to walk away. We know this may be difficult to do, but when you stay, it prolongs the separation anxiety and may upset the other children in the process. Please know that we understand how difficult this is! You are welcome to call the church for an update on your child!

A sign-in sheet is located outside each classroom. Always sign-in your child and note how you or an alternate adult may be reached in case of an emergency.

If your child is to be picked up by someone other than yourself, you must complete a pink “Pick Up Slip” provided at the front desk. The person will be asked to show his/her driver’s license before your child will be permitted to leave the building.

If an emergency arises where you are unable to complete a “Pick Up Slip”, we must receive a telephone call from you or your spouse.

If these steps are not taken we will not release your child. We understand that this procedure may cause some inconvenience but we must put the safety of your child first.

Custody papers MUST be provided to the MDO Director.
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Refreshments and Lunch

Each child must bring their own finger food and cup for lunch. Please note, we do not refrigerate or heat lunches. Placing a freezer pack in the lunch box will keep cold items fresh. MDO provides a mid-morning snack. Sugar Babies, Gummie Bears, and Tart n' Tiny lunch foods should be cut up into bite sizes. Label all lunch boxes and cups! Alert the MDO Director and Teachers with any food allergies!

Some Suggestions for Lunch:
Sliced fruit- strawberries, oranges, blueberries, applesauce or fruit pouches. Grapes should be quartered.
Sliced veggies- carrots, cucumbers, bell peppers
Lunch Meat rolls like turkey or ham
Sliced cheese or cheese sticks
Crackers, pretzels, or granola bars
Fruit snacks

Please do not send messy items like Pizza Lunchables, shredded cheese or rice. These items generally end up on the floor!
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Birthdays

Your child may bring a small snack (donut holes or mini cupcakes) to celebrate his or her birthday. Please check with the teacher or Director for any food allergies. If your child would like to send home invitations to a party, please include one for every child in the class. The teacher will distribute them.
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Illnesses

Sick children are most comfortable at home. Please do not expose other children unnecessarily. Children MUST be fever free and diarrhea free for 48 hours without the aid of medication (Tylenol, Ibuprofen or other fever-reducing medications) before returning to Mothers' Day Out. Children with contagious diseases require a Doctor's release before being allowed to return to MDO. Children that appear ill will not be accepted. Teachers are not allowed to dispense medication.
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General Reminders

Children in the Gummie Bear, Tart n' Tiny, and Starburst classes must provide their own rest-time mat, blanket, lovey or any item that helps them rest.

Please apply sunscreen during the spring and summer months before arriving at MDO so our little ones will not get sunburned.

Please encourage your child not to bring their personal toys to MDO.

Clearly label all personal belongings (i.e. lunch boxes, coats, blankets, diaper bags, bottles, cups, extra clothes)
MDO is a place for children to play and learn. Depending on their age, they will be working with glue, glitter, paint, play dough, etc., as well as playing inside and out. They should be dressed in play clothes, such as shorts, jeans, etc. Closed toed shoes should be worn.

Hair bows, clips, and accessories probably shouldn't be worn since they are easily lost.
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Changes

During the course of the year, it may become necessary to make changes to policies, procedures, or this agreement, in order to meet the needs of the families and children attending MDO. All such changes shall become part of this agreement.
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Thank you for trusting MDO with your children! If you have any questions, please do not hesitate to ask! Email is the easiest and quickest way to reach me: mdo@sgbaptist.net or my office number is 972-271-5428 ext 105.

Laurie Wallace
Mother’s Day Out Director

By clicking each checkbox below, you affirm each of the following: *

I understand that an email from MDO will let me know if there is currently an opening for my child. Until I receive the confirmation, I will not bring my child to MDO.

I have read and agree to the Agreement with MDO

I give SGBC MDO permission to seek out medical treatment for my child in the event of a medical Emergency.

Required

Image Use

SGBC MDO asks your permission to photograph your child from time to time during school and publish it on Facebook.

I give SGBC MDO permission to photograph my child during school and publish it on Facebook.

I DO NOT GIVE SGBC MDO permission to photograph my child during school and publish it on Facebook.

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Parent/Guardian Signature *

Entering your name below will be accepted as your digital signature on this agreement.

Date *

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