2026 Little Stars Enrollment Forms
  • Little Stars Enrollment Forms

    Please reach out to the Little Stars Director at lstars@meridiansvs.com or 763-458-0064 with any questions.
  • Select role*
  • We are so excited you are joining the Little Stars Family!

    Our goal is to make the transition to our program comfortable for you, your child, and our teachers. We will work with you to schedule a time for you and your child to visit prior to their official first day. This “pre-visit” gives all of us the opportunity to get to know each other better and to ask questions. Usually, it’s a one-hour visit between 10-11am during the week.  We want you to see how our program is structured and what a typical day looks like. It’s important that you feel as comfortable as possible when you leave your child in our care. 

    We will request that all supplies be brought in at this time as well. We want to be prepared for your child on their first day so having all their items ready helps make the first morning go smoothly. This visit is not a requirement for enrollment, but we strongly recommend this visit if your schedule allows.


    Please complete the following forms and reach out to the Director if you have questions. Again, welcome to Little Stars!

     

  • If you need to submit a handwritten form, please visit the secure upload https://oriforms.jotform.com/231338605709963?jumpToPage=8 

  • General Information

  • Child's Date of Birth*
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  • Requested Start Date*
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  • Rows
  • Parent/Guardian 1 Information

  • What is Parent/Guardian 1 preferred method of contact?*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • What is Parent/Guardian 1 preferred method of contact?*
  • How would Parent/Guardian 1 prefer to communicate with Little Stars? (select all preferred)
  • Parent/Guardian 2 Information

  • What is Parent/Guardian 2 preferred method of contact?*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • What is Parent/Guardian 2 preferred method of contact?*
  • How would Parent/Guardian 2 prefer to communicate with Little Stars? (select all preferred)
  • Signatures

    I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
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  • Date of Signature:*
     - -
  • Emergency Contacts and Authorized Pick-Up Persons

    MN Department of Licensing requires at least 2 persons listed as Emergency Contacts in the event a parent cannot be reached in an emergency or when there is an injury requiring medical attention. This person is authorized to make decisions on your behalf to ensure timely and medically necessary care. Please complete the following:
  • Child's Date of Birth*
     - -
  • Emergency Contact 1

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Is Emergency Contact 1 authorized to pick up your child from Little Stars in the event you are unable to?*
  • Emergency Contact 2

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Is Emergency Contact 2 authorized to pick up your child from Little Stars in the event you are unable to?*
  • Authorized Pick-Up Persons

    MN Department of Licensing requires at least 2 Authorized Pick-up Persons to be listed in the event a you are unable to up your child. If your Emergency Contacts listed above are not authorized to pick your child up, please complete the following:
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Signatures

    I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
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  • Date of Signature:*
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  • Health Information

  • Child's Date of Birth*
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  • Format: (000) 000-0000.
  • Dental

    Please list your dental provider if your child has not seen a provider yet.
  • Format: (000) 000-0000.
  • Hospital

  • In the event of an emergency, do you have a preferred hospital your child should be routed to?*
  • HIDE- In the event of an emergency, do you have a preferred hospital your child should be routed to?
  • Allergies and Specific Diet Requests

  • Does your child have allergies?*
  • Are you concerned your child may be prone to potential allergies?*
  • Does your child require a prescribed or specialized diet?*
  • Does your child have any special needs?*
  • Does your child have specific medical needs?*
  • Immunizations: Prior to or on your child’s first day, we require a current immunization record. State regulations require this to be submitted before we can provide care for your child. 

    Health Care Summary: You will receive a Health Care Summary upon enrollment that requires your child’s medical provider to complete. This is required to be completed, signed, and submitted within the first 30 days of care in our program.  Services will be suspended or terminated if the Health Care Summary is not completed and returned.

  • Compliance

    If any of the above information changes, you must inform the program promptly. MN State child care licensing regulations are on file at the center and are available for review upon request. Certain state child care licensing regulations have requirements in addition to those contained in this handbook.
  • Signatures

    I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
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  • Date of Signature:*
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  • Authorizations

  • Child's Date of Birth*
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  • To Act in an Emergency:

  • I authorize Little Stars staff to act in my child’s best interest in the event of a medical or other emergency. I understand that center staff will attempt to contact me immediately; however, in the event that I cannot be reached, or when a delay may further jeopardize my child’s health, I hereby authorize Little Stars staff to act on my behalf and to take the emergency measures including those listed below if deemed necessary by center staff or by medical authorities for the care and protection of my child:

    Administer first aid and/or cardiopulmonary resuscitation, transport my child via ambulance or other emergency medical service to a local hospital or other urgent care facility, if deemed necessary by paramedics, police, or other emergency personnel, obtain any emergency medical or dental treatment deemed necessary by medical authorities. Arrange transport for my child to a local emergency shelter in the event of an emergency evacuation of the center. 

    If I wish to request a religious or personal exemption to Little Stars' practice of securing necessary emergency medical treatment, I understand state child care licensing authorities must be consulted to determine if such an exemption may be granted.

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  • Date of Signature:*
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  • Little Stars Emergency Plan:

  • I acknowledge that I may request a copy of Little Star's emergency, fire, and storm plans that are practiced and recorded monthly. Information about these practice drills are included in this handbook.

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  • Date of Signature:*
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  • Administration of Medications:

  • Individual state child care licensing regulations regarding medication must be followed. Any mandatory state form regarding administration of prescription or non-prescription medication must also be completed and signed by a parent/guardian.

    In the event my child requires prescription medication, (supplied by the parent), while at Little Stars, I authorize Little Stars Teachers to administer medically prescribed PRN medications, as approved by a physician, according to the instructions on the medication. I understand that staff cannot deviate from those instructions and that all medically prescribed medications are in the original packaging and have not expired.

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  • Date of Signature:*
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  • Illness Policies

  • If the center staff notifies me that my child is ill, I must pick up my child as soon as possible and no later than one (1) hour after being contacted. Please refer to the health policies in the Little Stars Parent Handbook for illness specific exclusions/readmittance policies.

    If my child contracts a reportable contagious disease, my child may return only with a physician/health care professional’s note indicating that my child is no longer contagious.

    I agree to promptly provide information to the center regarding any conditions, illnesses, allergies, or other special needs that my child has, within 24 hours of onset/occurrence, which may require specific care or attention and agree to provide additional documentation as needed. We are required to inform the MN Dept of Health when certain communicable illness have been diagnosed and/or send illness to alerts to all families and staff. These communications will not reveal the name of your child or parent info.

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  • Date of Signature:*
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  • Immunizations

  • I understand that prior to my child's first day of care, I will be asked to provide the center with the most current immunization information for my child. If I wish to request a religious or medical exemption to Little Star's practice of securing immunization information, I understand my request must meet state child care licensing regulations.

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  • Date of Signature:*
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  • Health Care Summary Plan:

  • MN Dept of Children, Youth and Families requires a Health Care Summary on file within 30 days from your child's first date of care. This form is required to be completed and signed by your child's health care provider. Child care services can be suspended until the Health Care Summary is submitted to Little Stars.

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  • Date of Signature:*
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  • External Product Use:

  • I hereby give Little Stars permission to apply one or more of the following external preparations, in accordance with the directions for use on the container I understand that Little Stars will use the following products on my child as needed during the day:

    PROVIDED BY LITTLE STARS

    Sensitive skin baby wipes, hand soap, sunscreen (ages 6 months +), moisturizing cream (Aquaphor), bug spray, first aid ointment, band aids/wound coverings, hydrocortisone cream for itching.

    PROVIDED BY PARENT FOR USE ON THEIR CHILD ONLY

    -Diaper rash cream (provided by the child’s parent - labeled with first and last name and not expired).

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  • Date of Signature:*
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  • Viewing of health records:

  • Child care centers in Minnesota are required to engage the services of a Nurse/Health Consultant to review health policies and procedures and children’s records. Additionally, DYCF may request to review them as part of the re-licensing process or there is a specific concern. Your signature below allows consent for review of my child’s records by the nurse/health consultant and the DCYF licensor/licensing commissioner.

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  • Date of Signature:*
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  • Walking Trips:

  • I give permission for my child to leave the center for outdoor exercise and educational purposes, with the understanding that my child will be always accompanied by center staff and under proper staff supervision.

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  • Date of Signature:*
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  • Water Activities:

  • I give permission for Little Stars to include my child in supervised water activities, including indoor water activities at the center. Water activities will meet state child care licensing regulations.

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  • Date of Signature:*
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  • Tuition:

  • You understand that tuition payments are paid on the 1st of each month for the entire month. An invoice is sent 10-15 days prior for your review. Please contact the Director for any questions regarding tuition.

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  • Date of Signature:*
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  • To Photograph:

  • I authorize the staff at Little Stars to photograph my child for purposes of internal use. These include photographs posted on our childcare app, photos displayed in the classroom or internal classroom newsletters. We will request written permission for any photos/videos to be used outside those listed above, prior to publishing them. You understand you have the right to refuse permission at that time.

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  • Date of Signature:*
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  • Communication:

  • You agree to Little Stars communicating with you by telephone, text, e-mail, our childcare app, or other means. We will contact you via your preferences listed above first. If we are unable to reach you through those methods, we will attempt to contact you through your other contact information you provided. Written communication may be sent home with authorized pick-up persons or law enforcement when deemed necessary.

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  • Date of Signature:*
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  • Childcare outside of the center:

  • To maintain the professional status of center staff and prevent any potential conflict of interest, babysitting by center staff members is discouraged. However, should you choose to hire any center staff members, it must be outside the center premises and with the understanding that such arrangements and payment for services are solely between you and the center staff member. The center and Little Stars do not sanction the arrangements, and you agree to hold Little Stars harmless from any such arrangement. Please sign and acknowledge you are aware of this policy.

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  • Date of Signature:*
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  • Little Stars Parent Handbook

  • I have read and agree to the policies listed in the current Parent Handbook I received digitally. By signing below, you acknowledge you understand and agree to the policies in the Little Stars Parent Handbook. If I have questions regarding these policies, I agree to contact the Program Director for clarification.

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  • Date of Signature:*
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  • The terms of this Agreement, including the tuition and fees, are subject to change in whole or in part by the center with 30-day’s notice. This Agreement may be terminated by the center at any time.

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  • Date of Signature:*
     - -
  • Signatures

    I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
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  • Date of Signature:*
     - -
  • Should be Empty: