Early Childhood Forms

 

In order to attend the Early Childhood Program, each child must have an up to date PHYSICAL FORM on file.

  • A written statement, signed by a physician, that the child has had a complete physical examination within one year prior to admission.
  • Physical form must be updated each year.
  • A physician’s certificate that your child has been successfully immunized in accordance with the current MA Department of Public Health Immunization Guidelines.
  • http://www.mass.gov/eohhs/docs/dph/cdc/immunization/guidelines-ma-school-requirements.pdf
  • Proof that child, regardless of risk, has been screened for lead poisoning at least once between 9 and 12 months of age.  The state requires an annual lead screening until age 48 months.

COMPLETING ENROLLMENT FORMS

WCCC partners with the company UpBup  https://upbup.com which is an on-line platform for parents to electronically sign and submit enrollment forms.  All parents will receive an email from the Program Director prior to their child’s first day of school with information about how to get started with UpBup.  Parents will use the secure UpBup platform to submit their child’s information once and then the system will use that data to populate forms required by our licensing agency the Department of Early Education and Care.  Parents are asked to update information throughout the year as changes occur.

Finally, if your child has an allergy or a chronic health issue (i.e. asthma, seizure disorder or diabetes):  Please email or call the Program Director to set up a meeting to complete your child’s Individual Health Plan form prior to each school year.

Children with a chronic health issue will need the following forms on file:

Form 11. Medication Permission Form

Form 11. Medication Permission Form-PDF

This form is also required of all children who may need emergency medication like an Epipen or Inhaler. Parents and/or physicians must indicate in writing which symptoms should be present for us to administer each medication and may not just write “as needed.”

This form is required for us to administer medications such as acetaminophen, ibuprofen or benadryl when authorized by a parent.  We strongly recommend that each child have a Medication Permission Form signed by their child’s physician in order for us to dispense parent-provided non-prescription medication, as well as prescription medication needed for allergies or chronic health conditions.

Please take a minute to review FORM 11 to make sure that your physician has included both non-prescription medications (i.e. benedryl) and prescription medications (i.e. albuterol or epipen jr.).

Form 12. Allergy Posting Permission needs be filled out only if your child has an allergy.

Form 12. Allergy Posting Permission-PDF

Form 13. Individual Health Plan Form 2018 must be filled out by your physician if your child has a chronic health issue (i.e. asthma or diabetes) or an allergy.

Physicians must indicate in writing which symptoms should be present for us to administer any medication and may not just write “as needed.” The date and physician’s signature is required on all Individual Health Care Plans.

Form 15. Emergency Medication Consent Form must be filled out and signed by parents only if your child has a chronic health issue or allergy that might require medication  (i.e. benedryl, epipen, inhaler)  in an emergency.

Form 15. Emergency Medication Consent Form-PDF