Acknowledgment of Receipt

I, _____________________________________________, have received the following and will complete each one prior to my child/ren's first day of care:

- "Child Care Home Register"
- "Certificate of Immunization Status"
- "Permission Form"
- "Enrollment Questionnaire"
- "USDA Food Program Enrollment Form"
- "Stacy's Little Stars Policies and Procedures Handbook"
- "Permission to Access Pets"

I understand that prior to enrolling my child/ren in Stacy's Little Stars Childcare I need to complete all of the above forms and read the Policies and Procedures Handbook. I understand that the handbook is my contract with Stacy's Little Stars Childcare and I agree to abide by it. I also undersatnd that it is my responsibility to inform Stacy's Little Stars Childcare of any changes of the information provided on the forms.



Signed: ___________________________________ Date: _________________

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