Enrollment Forms

Required Forms for New and Returning Families

Once you have been offered a contract for child care, several forms are required to be completed before your child's first day at a MCCA program. You will need Adobe Reader to view and/or print these forms. You can fill out "All About Me" and the "Emergency Form" on the computer as they are in a writable pdf format. If you wish to do it by hand, you may print them out and do so.

Return all completed forms to your director.

For your Information:

Age Appropriate Immunization Requirements For Children Enrolled In Child Care Programs (MSDE)
A Parent's Guide to Regulated Child Care

Forms to fill out and return to your Center Director:

All About Me (MCCA 7/15)
Emergency Form (MSDE #1214, date 7/15)
Health Inventory (MSDE #1215, revised 5/16)
Medication Authorization (MSDE #1216, revised 8/15)
Immunization Certificate (DHMH Form 896 revised 2/14
Blood Lead Test Certificate (DHMH FORM 4620)
Emergency Health Plan (if necessary)
Allergy Action Plan (if necessary)
Asthma Action Plan (if necessary)
Extra-Curricular Permission Form (if necessary)
Additional permission forms required for summer:

Basic Needs Product Form
Water Safety Permission Form--Preschool
Children missing completed forms cannot be admitted into care.
Forms must be kept current and emergency infomation updated at least once a year.

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Description of MCCA Fees

3204 Tower Oaks Blvd., Suite 330, Rockville, MD 20852 Tel 301-984-7680 Fax