Enrollment Paperwork - The J of Greater Ann Arbor

JCC Ann Arbor on Instagram

JCC Ann Arbor on Facebook

Home
About Us
Departments
Calendar
Donate
Member Log In
- Login
- Become a Member
Contact Us

Early Childhood Center
About the ECC
New Enrollment
Activities
- PJ Library® at the J
- Family Shabbat
Parent Resources
Donate
Staff Links

ECC Enrollment Paperwork 2023-24

Email(Required)

Parent/Guardian Filling Out this Form(Required)

First Last

Child's Legal Name(Required)

First Last

ECC Permissions and Waivers

Diaper cream, sunscreen, and other topical non-prescription creams (please note: sunscreen will only be applied to children 6 months of age or older):(Required)

I give the ECC permission to apply diaper cream, sunscreen, and other topical (non-prescription) creams and lotions to my child. I understand that I will provide all sunscreen/cream/lotion that will be applied.

Insect Repellent (Select one):(Required)

I give the ECC permission to apply insect repellent (that I provide) to my child.

I will fill out a medication slip if I want the ECC to apply insect repellent.

Field Trips (any departure from our property including neighborhood walks and emergency evacuation requires this permission.)(Required)

I give my permission to the ECC for my child to be transported and/or participate in field trips.

I give permission for the JCC to use Photos/media of my child for these external uses (select all that apply):(Required)

Social Media/JCC Website

Email Campaign/Print Media

I do not give permission to use photos/media of my child for external use

No names or other identifying information will be used with any external use of photos/media

Parent Handbook 2024-2025

I have read, understand, and agree to the ECC Parent Handbook. The handbook can be found above(Required)

I agree to the policies and procedures laid out in the Parent Handbook

I have read, understand, and agree to the ECC Health and Illness Policy (found in the Parent Handbook):(Required)

I agree to the policies and procedures laid out in the ECC Health and Illness Policy

I have read, understand, and agree to the ECC Outside Food Policy (found in the Parent Handbook)(Required)

I agree to the policies and procedures laid out in the ECC Outside Food Policy

Pest Management Notification Policy

I have read and understand the Pest Management Notification Policy Found Above(Required)

I agree to the policies and procedures laid out in the Pest Management Notification Policy

Child Care Organizations Act Notification

I have read and understand the Child Care Organizations Act Notification Found Above(Required)

I agree to the policy.

Signature

Please type your name to indicate your understanding an agreement to the above Waivers and Permissions

Date

MM slash DD slash YYYY

MI Information Record and Emergency Contact Form

Please download and complete the MI form below, then attach it to the file upload box

MI Info Record and Emergency Contact Info

Upload Your Child's MI Form Here

Drop files here or

Accepted file types: pdf, png, jpg, word, Max. file size: 128 MB, Max. files: 1.

Health Form

Please download and have your physician complete the health form below. It can be uploaded here, emailed to [email protected], or faxed to us at 734-272-0062

Health Form

If you are uploading the Health Form, please attach it below:

Drop files here or

Max. file size: 128 MB, Max. files: 3.

Immunization Records can be uploaded below

Drop files here or

Max. file size: 128 MB, Max. files: 1.

Enrollment Record / Update

My Child Is(Required)

New to the ECC

Continuing at the ECC

For New Students

For Returning Children

Child's Information

What name would you like on your child's classroom labels?(Required)

Child's Date of Birth(Required)

MM slash DD slash YYYY

Child's Sex(Required)

Female

Male

Child's Gender(Required)

Boy

Girl

Non-Binary

Other

Primary Language(Required)

Any other languages spoken in the home(Required)

Parent Information

Name of Parent 1(Required)

First Last

Phone Number of Parent 1(Required)

Email of Parent 1(Required)

Enter Email Confirm Email

Occupation of Parent 1

Religious Affiliation of Parent 1

What does your child call Parent 1?

Primary Language of Parent 1

Name of Parent 2

First Last

Phone Number of Parent 2

Email of Parent 2

Enter Email Confirm Email

Occupation of Parent 2

Religious Affiliation of Parent 2

What does your child call Parent 2?

Primary Language of Parent 2

Household Information

Names of other adults in the home and their relationship to the child

Sibling(s) Name(s) and Date(s) of Birth

Birth History

Was your child either premature or very late? By How many weeks?

Did your child require any special medical care or prolonged hospitalization at birth?

Allergies

Does your child have any allergies or respiratory conditions such as Asthma?(Required)

Yes

No

Seasonal Allergies: What effect do they have on your child?

Contact Allergies: What effect do they have on your child?

Insect Allergies: What effect do they have on your child?

Food Allergies: What effect do they have on your child?

Medication Allergies: What effect do they have on your child?

Does your child have an Allergy Action Plan?(Required)

Yes

No

Please Upload their Allergy Action Plan Here or email [email protected]

Drop files here or

Accepted file types: jpg, png, pdf, word, Max. file size: 128 MB, Max. files: 2.

Does your child have an Asthma Action Plan?(Required)

Yes

No

Please Upload their Asthma Action Plan Here or email [email protected]

Drop files here or

Accepted file types: jpg, png, pdf, word, Max. file size: 128 MB, Max. files: 2.

Medication & Illness

Has your child had any serious illnesses?

Are there any medical issues your child's teacher needs to know about?

Does Your Child Take Medication Regularly?(Required)

Yes

No

Please describe the nature of the medication, the condition it is treating, and any reactions and side effects your child has.

Will your child take the medication during the day while at the ECC?(Required)

Yes

No

What medication and what time will it need to be administered?

Medication Permission Form

Upload the Medication Permission Form Here

Max. file size: 128 MB.

Social Emotional Development

Has your child ever been away from their parents? If so, why?

Does your child have separation anxiety? How is it best handled?

How does your child soothe themselves?

Has your child been in child care before?

Anything else you would like your child's teachers to know?

Age Specific Questions

Please choose your child's age group to navigate to the appropriate questions

2-12 Months

12-24 Months

2-3 Years

3-5 Years

Sleep

What is your child's sleeping pattern?

Has your child shown any sleeping problems? What kind?

Do you have any special ways of helping your child go to sleep? What are they?

Do you use a pacifier? When?

Nutrition

Has your child had any feeding problems?

Has your child had any eating problems?

Does your child have a good appetite and show interest in food?

What is your child's current feeding schedule?

What is your child's current eating schedule?

Is your child currently (select all that apply):

Breast Fed

Bottle (Formula) Fed

Bottle (Breast Milk) Fed

Other

Does your child drink cow's milk or an alternative?

Development Milestones

My child can (select all that apply):

Roll from Front to Back

Roll From Back To Front

Sit Up Independently

Move From One Location to Another (rolling, scooting, etc.)

Crawl

Walk

My child can (select all that apply):

Move From One Location to Another (rolling, scooting, etc.)

Crawl

Walk

At what age did your child walk alone?

Does child feed themselves with a spoon and/or fork?

Does your child drink from an open cup?

Social-Emotional Development

What are your child's fears and how do they react to them?

Any new fears or concerns your child may have?

Any changes to the family enviornment?

What form of behavior management do you use?

Potty Training

Please select the most relevant for the school day

We have not begun potty training

Wears diapers but tries the toilet

Wears underwear during waking hours - wears diapers/pull-ups during naptime

Wears underwear all school day

Additional Information

Anything else we should know?

Note below any items you feel may affect your child in any way. All information is confidential and is for the purpose of understanding and helping your child.

Special Needs: please describe any points in which the child needs help.

Δ

Enrollment Forms

These must be filled out and turned in prior to the start of each school year!

MI Info Record and Emergency Contact Info
Health Form – please have this filled out by your pediatrician. It can be faxed to us at 734-677-0109.

Home
About the J
Donate
Login

Copyright © 2026 The J of Greater Ann Arbor | All Rights Reserved.

Responsive Menu

Add more content here...

Home
About Us
▼
Departments
▼
Calendar
Donate
▼
Member Log In
▼
- Login
- Become a Member
Contact Us