Home
About Us
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Enrollment

Home
About Us
Programs
FAQ
Enrollment

718-712-2926

HOME
About Us
Programs
FAQ
Enrollment
Contact Us

Enrollment

Enroll Your Child with J&G Nurture and Care

Phone – 718-712-2926

Email – Info@jgnurture.com

Address – 196-01 119th Ave, Jamaica, NY 11412

Download The Form

At J&G Nurture and Care, we’re dedicated to providing a safe, nurturing, and educational environment for your child. Our enrollment process is simple, and we’re here to support you every step of the way. Fill out the form below to begin the enrollment process and join our family today!

Child Information

Full Name

Date of Birth

Age

Select gender

Male Female Other

Home Address

City

State

ZIP Code

Primary Language Spoken at Home

Parent/Guardian Information

Full Name

Relationship to Child

Phone Number

Email Address

Employer

Work Phone

Alternate Contact Name

Alternate Contact Phone

Emergency Contact (Not a Parent/Guardian)

Emergency Contact Name

Emergency Contact Phone

Relationship to Child

Authorized Pickup Persons

Name

Phone

Name

Phone

Medical Information

Child’s Doctor

Doctor’s Phone

Preferred Hospital

Allergies or Medical Conditions

Medications Currently Taking

Enrollment Details

Requested Start Date

Preferred Contact Method

Best Time to Reach

Program Enrolling In

Full-Time Care Part-Time Care After-School Program Drop-In Care

Days Attending

Mon Tue Wed Thu Fri

Additional Notes

I certify that the information provided above is accurate and complete to the best of my knowledge. I give permission for J & G Nurture and Care to obtain emergency medical treatment for my child if necessary.

GET IN TOUCH 718-712-2926 GET IN TOUCH 718-712-2926

Connecting Families and Building Bright Futures — One Child at a Time

Links

Home
About Us
Programs
FAQ
Enrollment

Our address

196-01 119th Ave, Jamaica, NY 11412

Send email

Info@jgnurture.com

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