All About Me - Photo - Activity

					                                    All About ME!!!!

                   Child’s Name ________________________Nickname: _______________________
I would like to take this time to welcome you and your family to my Daycare/preschool. I hope
to see you and your family often. If you could fill in the questions below to help me get to
know your child a little better makes my day and your child’s day run a lot smoother. It helps
me to know what to expect and be prepared.
Has your child been in daycare or preschool before? yes no
How long was your child there?_______________________________________________
Was your child happy there?_________________________________________________
Why did you leave? ___________________________________________________
What did you like best about your previous daycare or
What did you like least about your previous daycare/preschool?______________________________
How would you describe your child’s personality on a normal basis?
Happy     Moody       Quiet        Chatty Testing         Cooperative
Does your child have any siblings?
He/she has: _____ Brothers and _______Sisters.
Name ____________________ Age_____ Name______________________ Age____
Is your child able to play as hard as other children? Yes No
Does your child get along with other children? Yes No
Does your child take naps? Yes No
If Yes, do they have a special toy or blanket they will need to bring?   Yes No
What are your child’s eating habits?______________________________________________

What are some of your child’s favorite foods?____________________________________

What is your child’s favorite activities?___________________________________________

What type of discipline is used at home?_________________________________________
How does your child react to discipline?_________________________________________
Does your child have any fears?__________________________________________________
Does your child accept new people easy?_________________________________________
How does your child show affection?____________________________________________
Do you have back-up childcare for days we are closed & or ill? Yes No

What is the most important item for me to be aware of for your child, other than safety?
(I.e. Opportunities to explore, cognitive experiences, socialization, etc.)

Photographs and video are taken on different occasions such as birthdays, holidays, outings and
special occasions. We use these pictures/videos in our child care home for teaching, arts &
crafts, albums, our blog, and various other things.

Please mark the appropriate box:
□I give permission               □I do not give permission
To Little Learners to take photographs or have photographs taken of my child______________
should the occasion arise.

Please mark the appropriate box:
□I give permission               □I do not give permission
To Little Learners to take video’s or have video’s taken of my child___________________
should the occasion arise.

                   Outside Play & Playground Activities Release Form

My child _______________ can use: (Please circle)
Swings            Slides    Ride on cars

Wading Pools         Wagon    Climbing Wall
My child can’t use ___________________ Because_____________________

I will not hold my preschool/daycare provider responsible for any injuries or doctor bills while
using toys, going for walks or playing at the nearby playground, as long as children are being
supervised and all the toys are in good shape. Any broken toys will be fixed and if not fixable
immediately discarded.
I realize that once I sign this form I will be responsible for all medical and dental bills that could
occur while my child is present in my preschool/daycare provider’s home. I know that accidents
usually do not happen in my preschool/daycare provider’s home and she is very careful but I also
know that she can’t see everything going on at all times and be everywhere at once. So accidents
are bound to happen occasionally. I have read, understand, & agree to all of the above.


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