{"id":319,"date":"2020-06-18T10:12:20","date_gmt":"2020-06-18T15:12:20","guid":{"rendered":"https:\/\/andrewsmemorial.org\/childcare\/?page_id=319"},"modified":"2020-06-18T10:12:22","modified_gmt":"2020-06-18T15:12:22","slug":"re-enrollment","status":"publish","type":"page","link":"https:\/\/andrewsmemorial.org\/childcare\/re-enrollment\/","title":{"rendered":"Re-enrollment"},"content":{"rendered":"<div class=\"wpforms-container wpforms-container-full wpforms-block\" id=\"wpforms-318\"><form id=\"wpforms-form-318\" class=\"wpforms-validate wpforms-form\" data-formid=\"318\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/childcare\/wp-json\/wp\/v2\/pages\/319\" data-token=\"8ad0aa168f9bedc7f69d5a9c1d34795d\" data-token-time=\"1777637623\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-318-field_2-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"2\"><label class=\"wpforms-field-label\">Application for Reenrollment <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-318-field_2\" class=\"wpforms-field-required\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_2_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][2][]\" value=\"I would like my child to continue for the upcoming year.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_2_1\">I would like my child to continue for the upcoming year.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_2_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][2][]\" value=\"My child will ONLY be enrolled through the summer months.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_2_2\">My child will ONLY be enrolled through the summer months.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_2_3\" data-rule-check-limit=\"true\" name=\"wpforms[fields][2][]\" value=\"I will withdraw my child at the end of the school year.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_2_3\">I will withdraw my child at the end of the school year.<\/label><\/li><\/ul><div class=\"wpforms-field-description\">Please select one.<\/div><\/div><div id=\"wpforms-318-field_49-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"49\"><label class=\"wpforms-field-label\">CHILD NAME <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-318-field_49\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][49][first]\" required><label for=\"wpforms-318-field_49\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-318-field_49-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][49][last]\" required><label for=\"wpforms-318-field_49-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-318-field_3-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_3\">CHILD NICKNAME <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_3\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][3]\" required><\/div><div id=\"wpforms-318-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_6\">CHILD ADDRESS <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_6\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][6]\" placeholder=\"street city, state zip\" required><\/div><div id=\"wpforms-318-field_5-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_5\">CHILD DATE OF BIRTH <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_5\" class=\"wpforms-field-medium wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"99\/99\/9999\" name=\"wpforms[fields][5]\" required><\/div><div id=\"wpforms-318-field_48-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"48\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_48\">CHILD AGE <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-318-field_48\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][48]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>&#8212;<\/option><option value=\"Nursery (6wks-8mths)\"  class=\"choice-1 depth-1\"  >Nursery (6wks-8mths)<\/option><option value=\"Creeper (8mths-12mths)\"  class=\"choice-2 depth-1\"  >Creeper (8mths-12mths)<\/option><option value=\"Toddler 1 (12mths-18mths)\"  class=\"choice-3 depth-1\"  >Toddler 1 (12mths-18mths)<\/option><option value=\"Toddler 2 (18mths-24mths)\"  class=\"choice-4 depth-1\"  >Toddler 2 (18mths-24mths)<\/option><option value=\"Twos (2yrs)\"  class=\"choice-5 depth-1\"  >Twos (2yrs)<\/option><option value=\"Threes (3yrs, not potty trained)\"  class=\"choice-7 depth-1\"  >Threes (3yrs, not potty trained)<\/option><option value=\"Threes (3yrs, potty trained)\"  class=\"choice-6 depth-1\"  >Threes (3yrs, potty trained)<\/option><option value=\"K4 (4yrs-5yrs)\"  class=\"choice-8 depth-1\"  >K4 (4yrs-5yrs)<\/option><\/select><\/div><div id=\"wpforms-318-field_9-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_9\">CHILD GENDER <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-318-field_9\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][9]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>&#8212;<\/option><option value=\"Male\"  class=\"choice-1 depth-1\"  >Male<\/option><option value=\"Female\"  class=\"choice-2 depth-1\"  >Female<\/option><\/select><\/div><div id=\"wpforms-318-field_50-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"50\"><label class=\"wpforms-field-label\">FATHER NAME <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-318-field_50\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][50][first]\" required><label for=\"wpforms-318-field_50\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-318-field_50-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][50][last]\" required><label for=\"wpforms-318-field_50-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-318-field_11-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_11\">FATHER ADDRESS <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_11\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][11]\" placeholder=\"street  city, state zip\" required><\/div><div id=\"wpforms-318-field_12-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_12\">FATHER PREFERRED CONTACT TELEPHONE <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_12\" class=\"wpforms-field-medium wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][12]\" required><\/div><div id=\"wpforms-318-field_16-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_16\">FATHER HOME TELEPHONE<\/label><input type=\"text\" id=\"wpforms-318-field_16\" class=\"wpforms-field-small wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][16]\" ><\/div><div id=\"wpforms-318-field_17-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_17\">FATHER WORK TELEPHONE<\/label><input type=\"text\" id=\"wpforms-318-field_17\" class=\"wpforms-field-small wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][17]\" ><\/div><div id=\"wpforms-318-field_45-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"45\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_45\">FATHER eMAIL <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-318-field_45\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][45]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-318-field_15-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_15\">FATHER EMPLOYER <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_15\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][15]\" required><\/div><div id=\"wpforms-318-field_14-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"14\"><label class=\"wpforms-field-label\">FATHER INFORMATION <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-318-field_14\" class=\"wpforms-field-required\" data-choice-limit=\"4\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_14_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][14][]\" value=\"Responsible for Account\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_14_1\">Responsible for Account<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_14_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][14][]\" value=\"Child lives with\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_14_2\">Child lives with<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_14_3\" data-rule-check-limit=\"true\" name=\"wpforms[fields][14][]\" value=\"Emergency contact\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_14_3\">Emergency contact<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_14_4\" data-rule-check-limit=\"true\" name=\"wpforms[fields][14][]\" value=\"Authorized pickup\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_14_4\">Authorized pickup<\/label><\/li><\/ul><div class=\"wpforms-field-description\">Select all that apply.<\/div><\/div><div id=\"wpforms-318-field_51-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"51\"><label class=\"wpforms-field-label\">MOTHER NAME <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-318-field_51\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][51][first]\" required><label for=\"wpforms-318-field_51\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-318-field_51-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][51][last]\" required><label for=\"wpforms-318-field_51-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-318-field_19-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"19\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_19\">MOTHER ADDRESS <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_19\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][19]\" placeholder=\"street city, state zip\" required><\/div><div id=\"wpforms-318-field_20-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_20\">MOTHER PREFERRED CONTACT TELEPHONE <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_20\" class=\"wpforms-field-medium wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][20]\" required><\/div><div id=\"wpforms-318-field_21-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_21\">MOTHER HOME TELEPHONE<\/label><input type=\"text\" id=\"wpforms-318-field_21\" class=\"wpforms-field-small wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][21]\" ><\/div><div id=\"wpforms-318-field_22-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"22\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_22\">MOTHER WORK TELEPHONE<\/label><input type=\"text\" id=\"wpforms-318-field_22\" class=\"wpforms-field-small wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][22]\" ><\/div><div id=\"wpforms-318-field_46-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"46\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_46\">MOTHER eMAIL <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-318-field_46\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][46]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-318-field_24-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"24\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_24\">MOTHER EMPLOYER <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_24\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][24]\" required><\/div><div id=\"wpforms-318-field_25-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"25\"><label class=\"wpforms-field-label\">MOTHER INFORMATION <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-318-field_25\" class=\"wpforms-field-required\" data-choice-limit=\"4\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_25_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][25][]\" value=\"Responsible for Account\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_25_1\">Responsible for Account<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_25_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][25][]\" value=\"Child lives with\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_25_2\">Child lives with<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_25_3\" data-rule-check-limit=\"true\" name=\"wpforms[fields][25][]\" value=\"Emergency contact\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_25_3\">Emergency contact<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_25_4\" data-rule-check-limit=\"true\" name=\"wpforms[fields][25][]\" value=\"Authorized pickup\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_25_4\">Authorized pickup<\/label><\/li><\/ul><div class=\"wpforms-field-description\">Select all that apply.<\/div><\/div><div id=\"wpforms-318-field_52-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"52\"><label class=\"wpforms-field-label\">ALTERNATE PICKUP\/EMERGENCY CONTACT 1 NAME <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-318-field_52\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][52][first]\" required><label for=\"wpforms-318-field_52\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-318-field_52-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][52][last]\" required><label for=\"wpforms-318-field_52-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-318-field_29-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"29\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_29\">ALTERNATE PICKUP\/EMERGENCY CONTACT 1 RELATIONSHIP <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-318-field_29\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][29]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>&#8212;<\/option><option value=\"Parent\/Spouse\/Guardian\"  class=\"choice-1 depth-1\"  >Parent\/Spouse\/Guardian<\/option><option value=\"Grandparent\"  class=\"choice-3 depth-1\"  >Grandparent<\/option><option value=\"Relative\"  class=\"choice-4 depth-1\"  >Relative<\/option><option value=\"Friend\"  class=\"choice-5 depth-1\"  >Friend<\/option><\/select><\/div><div id=\"wpforms-318-field_28-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_28\">ALTERNATE PICKUP\/EMERGENCY CONTACT 1 ADDRESS <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_28\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][28]\" placeholder=\"street city, state zip\" required><\/div><div id=\"wpforms-318-field_27-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"27\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_27\">ALTERNATE PICKUP\/EMERGENCY CONTACT 1 PREFERRED TELEPHONE <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_27\" class=\"wpforms-field-small wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][27]\" required><\/div><div id=\"wpforms-318-field_30-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"30\"><label class=\"wpforms-field-label\">ALTERNATE PICKUP\/EMERGENCY CONTACT 1 INFORMATION<\/label><ul id=\"wpforms-318-field_30\" data-choice-limit=\"4\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_30_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][30][]\" value=\"Responsible for Account\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_30_1\">Responsible for Account<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_30_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][30][]\" value=\"Child lives with\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_30_2\">Child lives with<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_30_3\" data-rule-check-limit=\"true\" name=\"wpforms[fields][30][]\" value=\"Emergency contact\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_30_3\">Emergency contact<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_30_4\" data-rule-check-limit=\"true\" name=\"wpforms[fields][30][]\" value=\"Authorized pickup\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_30_4\">Authorized pickup<\/label><\/li><\/ul><div class=\"wpforms-field-description\">Select all that apply.<\/div><\/div><div id=\"wpforms-318-field_53-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"53\"><label class=\"wpforms-field-label\">ALTERNATE PICKUP\/EMERGENCY CONTACT 2 NAME <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-318-field_53\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][53][first]\" required><label for=\"wpforms-318-field_53\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-318-field_53-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][53][last]\" required><label for=\"wpforms-318-field_53-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-318-field_34-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"34\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_34\">ALTERNATE PICKUP\/EMERGENCY CONTACT 2 RELATIONSHIP <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-318-field_34\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][34]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>&#8212;<\/option><option value=\"Parent\/Spouse\/Guardian\"  class=\"choice-1 depth-1\"  >Parent\/Spouse\/Guardian<\/option><option value=\"Grandparent\"  class=\"choice-2 depth-1\"  >Grandparent<\/option><option value=\"Relative\"  class=\"choice-3 depth-1\"  >Relative<\/option><option value=\"Friend\"  class=\"choice-4 depth-1\"  >Friend<\/option><\/select><\/div><div id=\"wpforms-318-field_31-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"31\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_31\">ALTERNATE PICKUP\/EMERGENCY CONTACT 2 ADDRESS <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_31\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][31]\" placeholder=\"street city, state zip\" required><\/div><div id=\"wpforms-318-field_33-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"33\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_33\">ALTERNATE PICKUP\/EMERGENCY CONTACT 2 PREFERRED TELEPHONE <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_33\" class=\"wpforms-field-small wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][33]\" required><\/div><div id=\"wpforms-318-field_36-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"36\"><label class=\"wpforms-field-label\">ALTERNATE PICKUP\/EMERGENCY CONTACT 2 INFORMATION <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-318-field_36\" class=\"wpforms-field-required\" data-choice-limit=\"4\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_36_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][36][]\" value=\"Responsible for account\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_36_1\">Responsible for account<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_36_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][36][]\" value=\"Child lives with\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_36_2\">Child lives with<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_36_3\" data-rule-check-limit=\"true\" name=\"wpforms[fields][36][]\" value=\"Emergency contact\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_36_3\">Emergency contact<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_36_4\" data-rule-check-limit=\"true\" name=\"wpforms[fields][36][]\" value=\"Authorized pickup\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_36_4\">Authorized pickup<\/label><\/li><\/ul><div class=\"wpforms-field-description\">Select all that apply.<\/div><\/div><div id=\"wpforms-318-field_54-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"54\"><label class=\"wpforms-field-label\">ALTERNATE PICKUP\/EMERGENCY CONTACT 3 NAME <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-318-field_54\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][54][first]\" required><label for=\"wpforms-318-field_54\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-318-field_54-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][54][last]\" required><label for=\"wpforms-318-field_54-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-318-field_42-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"42\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_42\">ALTERNATE PICKUP\/EMERGENCY CONTACT 3 RELATIONSHIP <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-318-field_42\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][42]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>&#8212;<\/option><option value=\"Parent\/Spouse\/Guardian\"  class=\"choice-1 depth-1\"  >Parent\/Spouse\/Guardian<\/option><option value=\"Grandparent\"  class=\"choice-2 depth-1\"  >Grandparent<\/option><option value=\"Relative\"  class=\"choice-3 depth-1\"  >Relative<\/option><option value=\"Friend\"  class=\"choice-4 depth-1\"  >Friend<\/option><\/select><\/div><div id=\"wpforms-318-field_38-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"38\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_38\">ALTERNATE PICKUP\/EMERGENCY CONTACT 3 ADDRESS <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_38\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][38]\" placeholder=\"street city, state zip\" required><\/div><div id=\"wpforms-318-field_39-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"39\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_39\">ALTERNATE PICKUP\/EMERGENCY CONTACT 3 PREFERRED TELEPHONE CONTACT <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_39\" class=\"wpforms-field-small wpforms-field-required wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-mask=\"(999) 999-9999\" name=\"wpforms[fields][39]\" required><\/div><div id=\"wpforms-318-field_41-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"41\"><label class=\"wpforms-field-label\">ALTERNATE PICKUP\/EMERGENCY CONTACT 3 INFORMATION <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-318-field_41\" class=\"wpforms-field-required\" data-choice-limit=\"4\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_41_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][41][]\" value=\"Responsible for account\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_41_1\">Responsible for account<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_41_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][41][]\" value=\"Child lives with\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_41_2\">Child lives with<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_41_3\" data-rule-check-limit=\"true\" name=\"wpforms[fields][41][]\" value=\"Emergency contact\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_41_3\">Emergency contact<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-318-field_41_4\" data-rule-check-limit=\"true\" name=\"wpforms[fields][41][]\" value=\"Authorized pickup\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-318-field_41_4\">Authorized pickup<\/label><\/li><\/ul><div class=\"wpforms-field-description\">Select all that apply.<\/div><\/div><div id=\"wpforms-318-field_43-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"43\"><label class=\"wpforms-field-label\" for=\"wpforms-318-field_43\">PARENTAL AGREEMENT SIGNATURE <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-318-field_43\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][43]\" placeholder=\"first middle last\" required><div class=\"wpforms-field-description\">As a parent of a child registering for the upcoming year, I understand that the registration fee is non-refundable after I receive an acknowledgement from the administration accepting my child&#8217;s re-enrollment.  Approved re-enrollment is based on space availability, current account status, and parent\/child harmony with school program.  Any concerns regarding my child&#8217;s re-enrollment will be addressed before enrollment confirmation given to parent.<\/div><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-field wpforms-field-hp\"><label for=\"wpforms-318-field-hp\" class=\"wpforms-field-label\">Message<\/label><input type=\"text\" name=\"wpforms[hp]\" id=\"wpforms-318-field-hp\" class=\"wpforms-field-medium\"><\/div><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha wpforms-is-recaptcha-type-invisible\" ><div class=\"g-recaptcha\" data-sitekey=\"6Lf3xZ8UAAAAALiIvE60AX9GlbM-3PmeLcdlAA8g\" data-size=\"invisible\"><\/div><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"318\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/pages\/319\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-318\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"class_list":["post-319","page","type-page","status-publish","hentry"],"jetpack_shortlink":"https:\/\/wp.me\/PbwKKy-59","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/pages\/319","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/comments?post=319"}],"version-history":[{"count":1,"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/pages\/319\/revisions"}],"predecessor-version":[{"id":320,"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/pages\/319\/revisions\/320"}],"wp:attachment":[{"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/media?parent=319"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}