top of page

The Cozy Corner

Landing Page
Home
Registration
- Conact Form
- Medical Form
Discover Our Cozy Corner
Programs

Getting To Know Your Child

This information helps us provide the best possible care and support for your child’s individual needs.

What are your child's favorite activities, special interests, or talents?

How does your child typically handle separation?

What helps to comfort them?

Please describe your child's napping routine (if applicable):

Is your child potty trained?*

What words does your child use for urination/bowel movements?*

Permissions & Agreements

Please initial next to each statement to indicate your consent.

Medical Care: I authorize The Cozy Corner staff to obtain emergency medical care for my child if i cannot be reached immediately. I agree to be responsible for any resulting medical expenses.

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Topical Ointments: I give permission for staff to apply topical ointments (parent-provided) such as sunscreen, diaper cream, and insect repellent as needed.

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Local excursions: I give permission for my child to participate in short, supervised walks and excursions in the immediate neighborhood (e.g., to a local park or library). Parents will be notified of any off-site trips in advance.

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Photography & Video Release: I understand that photos and videos may be taken of the children for classroom projects and to share with parents via our private communication app.

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

I Also Release: give permission for my child’s photo/video to be used for promotional purposes (e.g,, on our website, social media, or brochures), without compensation. No names will be used.

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Signature*

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

info@mysite.com

123-456-7890

500 Terry Francine Street, 6th Floor, San Francisco, CA 94158

Accessibility Statement

Terms & Conditions

© 2035 by The Cozy Corner. Powered and secured by Wix

bottom of page