An Exceptional
Child Care Program

Home Enrollment Packet

Download and complete our Enrollment Packet. After clicking the downloadable link, the form will be saved to your computer. From here it can be opened and printed. Most of the form can be filled out on the computer for your convenience. Once completed, please print the form out, sign in the designated areas, and return to Country Home where you are interested in registering your child.

**Please note that it is required that we have your hand written signature in the designated areas**