Childcare Forms



I'm currently in the process of changing from paper to electronic forms. Once the conversion is complete the only paper form needed will be the one with your personal signature authorizing your electronic signature on all childcare forms. Until then, all forms must be completed, signed and initialed by both parents, and returned before I will assume the responsibility of caring for your child. Any document with missing information will be returned to you to complete.  If you have any question regarding any of the documents, please contact me at (603) 893-6385.

Parent Provider Agreement


Child Registration and Emergency Information


Child Health Form


Medical Authorization


Authorization To Administer Prescription and Nonprescription Medication


Authorization To Release Child


Authorization To Allow Child To Leave Supervision of Childcare Provider


Authorization For Transportation


Immunizations Certificate of Religious Exemption In A Childcare Program


Physical Examination Certificate of Religious Exemption In A Childcare Program