Enroll Online

Before you start, please read our Company Handbook by clicking here, because you'll be asked to agree to its terms when you submit your enrollment information!

Requested Enrollment Start Date
Requested Enrollment Start Date
We can usually accommodate next-day start dates, if needed.
Parent Information
Let us get to know more about you! If there isn't a secondary parent, the secondary parent does not have custody, or you do not wish to disclose secondary parent information, please leave that information blank.
Primary Parent Name *
Primary Parent Name
Primary Parent Phone Number
Primary Parent Phone Number
Primary Parent Date of Birth *
Primary Parent Date of Birth
Address (Where Child Lives, Primarily) *
Address (Where Child Lives, Primarily)
Primary Parent Work Address
Primary Parent Work Address
Primary Parent Work Phone Number
Primary Parent Work Phone Number
Secondary Parent Name
Secondary Parent Name
Secondary Parent Phone Number
Secondary Parent Phone Number
Secondary Parent Employer Address
Secondary Parent Employer Address
Secondary Parent Work Phone Number
Secondary Parent Work Phone Number
Child Information
We have space on this form for two children. Please only give us the information of the child(ren) who will be attending Foundations. If you happen to need to add additional children, we can do so at the center or you can fill out this form a second time. If you only have one child, leave information for Child #2 blank.
Child #1 Name *
Child #1 Name
Child #1 Date of Birth *
Child #1 Date of Birth
Is Child #1 In Good Health? *
Is Child #1 Toilet Trained *
Allergies, sensitivities, emotional triggers, etc. Anything that will help with transitioning your child into our environment.
Child #2 Date of Birth
Child #2 Date of Birth
Is Child #2 In Good Health?
Is Child #2 Toilet Trained?
Designated Authorized Persons
Designated Authorized Persons are individuals who are regularly allowed to pick up your child from Foundations. We suggest listing at least one person as an emergency contact. You are not required to list any persons in this section.
Designated Authorized Person #1
Designated Authorized Person #1
Phone Number
Phone Number
Emergency Contact?
Can we contact them in case of emergency?
Designated Authorized Person #2
Designated Authorized Person #2
Phone Number
Phone Number
Emergency Contact
Designated Authorized Person #3
Designated Authorized Person #3
Phone Number
Phone Number
Emergency Contact?
Designated Authorized Person #4
Designated Authorized Person #4
Phone Number
Phone Number
Emergency Contact?
Physician Information
The State of Nebraska asks that we keep information about children's physicians in the event of an emergency.
Physician's Office Phone Number *
Physician's Office Phone Number
Agreements
You're almost done! By selecting the "I Accept" option and typing your name, you are signing this agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting the "I Accept" option and typing your name, you consent to be legally bound by this Agreement's terms and conditions. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting contract between you and Foundations Progressive Learning Center, Inc. You also represent that you are authorized to enter into this Agreement for all persons who own or are authorized to access any of your accounts and that such persons will be bound by the terms of this Agreement. You further agree that each use of your E-Signature in obtaining a Foundations Progressive Learning Center, Inc. service constitutes your agreement to be bound by the terms and conditions of the Foundations Progressive Learning Center, Inc. Company Handbook as they exist on the date of your E-Signature.
Competency Agreement *
You have determined that Foundations Progressive Learning Center’s staff and administration members are competent to administer medications to your child should this ever be a requirement.
Consent to Contact Physician *
In an emergency, Foundations Progressive Learning Center, Inc. has my permission to call an ambulance, or contact my child’s physician to obtain medical treatment. In most emergencies, 911 is called and the child is transported to the nearest hospital and treated by the on-call physician. The parent or guardian of the child is notified as soon as possible.
Consent to Release Child *
Foundations Progressive Learning Center, Inc. has my permission to release my child into the care of any of the emergency contacts listed on his/her registration form if I cannot be reached in the event of an emergency.
Agreement to Company Handbook *
I agree to the terms and policies outlined in the “Company Handbook” tendered to me by Foundations Progressive Learning Center, Inc. at the time of my child’s enrollment. All of the information in the handbook has been explained to me and I agree to accurately comply with the terms and policies as they are written and as they have been explained to me.
Enrollment Agreement *
By signing below, I am entering into an agreement that all of the information I have provided in this document is accurate and complete. My child is enrolling into Foundations Progressive Learning Center and I am agreeing to the terms and policies outlined in the handbook of Foundations Progressive Learning Center, Inc.

Kinderlime

We use an app called Kinderlime to track student attendance and communicate with parents about children's day. Please click here to download the Kinderlime app. After enrollment is processed you will receive an email so you can set up your Kinderlime account.