Welcome to the Little Discoveries family!

Learn how we can support a positive transition into our program. This form is required for all families and will be reviewed as part of our intake process.

Please note: Completion of this form does not guarantee enrollment. Admissions decisions are based on group dynamics, capacity, and the ability to support your child safely and successfully. We are committed to inclusive and non-discriminatory practices, and we do not make decisions based on disability, diagnosis, race, gender, religion, or family background.

Parent/Caregiver | Inquiry

Child’s Full Name*

Date of Birth*

Preferred Name/Nickname

Desired Start Date*

Which enrollment option are you interested in?*

Scheduled Drop-Off Time*

Scheduled Pick-Up Time*

Preferred Location*

Parent/Guardian 1

First Name*

Last Name*

Phone Number*

Email Address*

Primary Language Spoken at Home

Siblings & Ages

What does a typical day look like for your child?*

Does your child nap regularly?*

Nap Details

(time & length, special blanket, pacifier, etc.)

What helps your child feel safe and comfortable in new environments?*

Allergies, dietary needs, or medical conditions we should know about?*

Has your child received any developmental screenings or evaluations?*

Please upload IEP, IFSP, or evaluation documents*

Has your child received or been referred for support services (e.g., speech, OT, ABA)?*

Brief description

What strategies or supports help your child succeed in group settings? *

Select all areas where your child may benefit from extra support*

Are there any behaviors that may impact your child’s or others’ safety?*

Please Describe

How does your child respond to new environments or caregivers?*

Previous Program or Provider*

Anything else you’d like to share to help your child succeed?*

Additional Contact Person

First Name

Last Name

Phone Number

Email Address

I give permission for Little Discoveries to contact my child’s former provider(s) for collaboration purposes.*

Yes

Acknowledgement & Signature

Signature

Acknowledgement & Signature

I understand that this form is part of Little Discoveries' intake process and that the completion does not guarantee enrollment.

I acknowledge that enrollment decisions are based on safety, group dynamics, staffing, and program fit. I understand that Little Discoveries does not make decisions based on disability, race, religion, gender, or diagnosis and complies with all ADA and EEC regulations.