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Welcome To The Children's Club House

Online Enrollment Form

2026 - 2027

​New Club House Families:

Please schedule and complete a facility tour before beginning the enrollment process. Following your tour, our office will provide registration instructions.

​

Returning Club House Families:

You may complete your annual enrollment registration without scheduling another tour.

 

A $100 non-refundable annual registration fee and your child's required health assessment must be submitted directly to the center.

Official enrollment is subject to availability and confirmation by our office.

To finalize the enrollment process, all required parent/legal guardian signatures must be completed in person at The Children’s Club House, LLC.  Although enrollment information is submitted electronically, parents/legal guardians are required to visit the center to review, acknowledge, and sign all applicable enrollment agreements, consent forms, and required documentation.

Please Note: Submission of the online enrollment form does not constitute completion or final approval of enrollment. Enrollment will be finalized once all required documentation, signatures, and applicable fees have been received and verified by the center.

CHILD'S INFORMATION

Child's Date of Birth
Month
Day
Year
Requested Enrollment Start Date
Month
Day
Year
Early Learning Program Requested
Enrollment Type

PARENT/GUARDIAN INFORMATION

Relationship To Child

EMERGENCY CONTACT & AUTHORIZED PICK UP PERSON

Emergency Contact Is Authorized To Pick Up The Child
Yes
No

CHILD'S MEDICAL INFORMATION

Health Assessment / Immunization Record Requested

I do understand that it is my responsibility, the parent/legal guardian to obtain and submit a completed Child Health Assessment from their child's licensed health care provider.
Yes
No
Does your child have ANY known allergies?
Yes
No
Does your child have any medical conditions OR special health care needs?
Yes
No
Does your child require an Individualized Health Care or Emergency Action Plan?
Yes
No
Unsure

ADDITIONAL PERMISSION / AUTHORIZATIONS

My child has my permission to go on all educational trips, including neighborhood walks, with his/her class, when accompanied by the teacher during the school year.
Yes
No
My child has my permission to participate in outdoor activities, (physical, playground equipment & leisurely play). I will not hold “The Club House” responsible for any accidents that may occur accidentally as a result of my child freely playing.
Yes
No
Photographs and videos of my child may be used for educational purposes, newsletters, yearbooks, the center's official website, social media platforms, promotional materials, and news or publicity releases.
Yes
No
“The Children’s Club House” staff has my permission to apply sunscreen and/or repellant on my child, if needed.
Yes
No
My child has my permission to be transported by The Children's Club House and / or staff person, if needed.
Yes
No

PRIMARY PARENT / GUARDIAN SIGNATURE

To finalize the enrollment process, all required parent / guardain signatures must be completed in person at The Children's Club House.

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The Children's Club House , LLC.
1830 W. 2nd Street ~ Chester, PA 19013
School Office Phone 610-485-4090   School Director Phone 484-390-3169 
Monday - Friday 7:00AM - 6:00PM
www.thechildrensclubhouse.org     www.thegrayexperience.com

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