{"id":1192,"date":"2021-07-05T23:35:18","date_gmt":"2021-07-05T23:35:18","guid":{"rendered":"https:\/\/funtimelearningcenterinc.com\/?page_id=1192"},"modified":"2021-07-28T16:23:29","modified_gmt":"2021-07-28T16:23:29","slug":"parent-enrollment-form","status":"publish","type":"page","link":"https:\/\/funtimelearningcenterinc.com\/index.php\/parent-enrollment-form\/","title":{"rendered":"Parent Enrollment Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1192\" class=\"elementor elementor-1192\" data-elementor-settings=\"[]\">\n\t\t\t\t\t\t<div class=\"elementor-inner\">\n\t\t\t\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-01295ba elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"01295ba\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6b40228\" data-id=\"6b40228\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a687454 elementor-widget elementor-widget-image\" data-id=\"a687454\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-image\">\n\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/funtimelearningcenterinc.com\/wp-content\/uploads\/2021\/05\/cropped-funtime-final-1.png\" title=\"cropped-funtime-final-1.png\" alt=\"cropped-funtime-final-1.png\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3d4246a elementor-widget elementor-widget-heading\" data-id=\"3d4246a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Enrollment Form<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-93ffe98 elementor-button-align-end elementor-widget elementor-widget-form\" data-id=\"93ffe98\" data-element_type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"New Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"1192\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"93ffe98\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_efd692e elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_efd692e\" class=\"elementor-field-label\">Date :<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_efd692e]\" id=\"form-field-field_efd692e\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-70\">\n\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">Name:<\/label><input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_cfffcbc elementor-col-30\">\n\t\t\t\t\t<label for=\"form-field-field_cfffcbc\" class=\"elementor-field-label\">Child\u2019s Age:<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_cfffcbc]\" id=\"form-field-field_cfffcbc\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-email elementor-col-50 elementor-field-required\">\n\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">Child\u2019s Birthday:<\/label><input size=\"1\" type=\"text\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_c4b1b06 elementor-col-50 elementor-field-required\">\n\t\t\t\t\t<label for=\"form-field-field_c4b1b06\" class=\"elementor-field-label\">Nickname :<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_c4b1b06]\" id=\"form-field-field_c4b1b06\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" aria-required=\"true\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_31e14f9 elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_31e14f9\" class=\"elementor-field-label\">Address:<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_31e14f9]\" id=\"form-field-field_31e14f9\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_42717b6 elementor-col-100\">\n\t\t\t\t\tContact Information:\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_15be34c elementor-col-70\">\n\t\t\t\t\t<label for=\"form-field-field_15be34c\" class=\"elementor-field-label\">Mom's  name :<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_15be34c]\" id=\"form-field-field_15be34c\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_d022de1 elementor-col-33\">\n\t\t\t\t\t<label for=\"form-field-field_d022de1\" class=\"elementor-field-label\">Home Phone <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_d022de1]\" id=\"form-field-field_d022de1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_4396bf1 elementor-col-33\">\n\t\t\t\t\t<label for=\"form-field-field_4396bf1\" class=\"elementor-field-label\">Work Phone <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_4396bf1]\" id=\"form-field-field_4396bf1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_1b8d0c0 elementor-col-33\">\n\t\t\t\t\t<label for=\"form-field-field_1b8d0c0\" class=\"elementor-field-label\">Cell Phone <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_1b8d0c0]\" id=\"form-field-field_1b8d0c0\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_8135e9b elementor-col-70\">\n\t\t\t\t\t<label for=\"form-field-field_8135e9b\" class=\"elementor-field-label\">Dad\u2019s name :<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_8135e9b]\" id=\"form-field-field_8135e9b\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_f94ac07 elementor-col-33\">\n\t\t\t\t\t<label for=\"form-field-field_f94ac07\" class=\"elementor-field-label\">Home Phone <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_f94ac07]\" id=\"form-field-field_f94ac07\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_88fec7d elementor-col-33\">\n\t\t\t\t\t<label for=\"form-field-field_88fec7d\" class=\"elementor-field-label\">Work Phone <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_88fec7d]\" id=\"form-field-field_88fec7d\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_9d7dbdc elementor-col-33\">\n\t\t\t\t\t<label for=\"form-field-field_9d7dbdc\" class=\"elementor-field-label\">Cell Phone<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_9d7dbdc]\" id=\"form-field-field_9d7dbdc\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_3954345 elementor-col-70\">\n\t\t\t\t\t<label for=\"form-field-field_3954345\" class=\"elementor-field-label\">Emergency Contact Person <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_3954345]\" id=\"form-field-field_3954345\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_4688f7e elementor-col-30\">\n\t\t\t\t\t<label for=\"form-field-field_4688f7e\" class=\"elementor-field-label\">Contact\u2019s phone <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_4688f7e]\" id=\"form-field-field_4688f7e\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_2d85e8a elementor-col-70\">\n\t\t\t\t\t<label for=\"form-field-field_2d85e8a\" class=\"elementor-field-label\">Emergency Contact Person <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_2d85e8a]\" id=\"form-field-field_2d85e8a\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_4e68ae4 elementor-col-30\">\n\t\t\t\t\t<label for=\"form-field-field_4e68ae4\" class=\"elementor-field-label\">Contact\u2019s phone <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_4e68ae4]\" id=\"form-field-field_4e68ae4\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_595ab07 elementor-col-100\">\n\t\t\t\t\tDo you have a backup care provider? \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_fbb0917 elementor-col-20\">\n\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper \">\n\t\t\t<select name=\"form_fields[field_fbb0917]\" id=\"form-field-field_fbb0917\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t<option value=\"Yes \">Yes <\/option><option value=\"No\">No<\/option>\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_2ef9ac7 elementor-col-100\">\n\t\t\t\t\tService Information:\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_9af39bd elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_9af39bd\" class=\"elementor-field-label\">Beginning date needing care <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_9af39bd]\" id=\"form-field-field_9af39bd\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group- elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Monday\" id=\"form-field--0\" name=\"form_fields[][]\"> <label for=\"form-field--0\">Monday<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Tuesday\" id=\"form-field--1\" name=\"form_fields[][]\"> <label for=\"form-field--1\">Tuesday<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Wednesday\" id=\"form-field--2\" name=\"form_fields[][]\"> <label for=\"form-field--2\">Wednesday<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Thursday\" id=\"form-field--3\" name=\"form_fields[][]\"> <label for=\"form-field--3\">Thursday<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Friday\" id=\"form-field--4\" name=\"form_fields[][]\"> <label for=\"form-field--4\">Friday<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"\" id=\"form-field--5\" name=\"form_fields[][]\"> <label for=\"form-field--5\"><\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_2e27ee9 elementor-col-50\">\n\t\t\t\t\t<label for=\"form-field-field_2e27ee9\" class=\"elementor-field-label\">Times you plan to drop your child off :<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_2e27ee9]\" id=\"form-field-field_2e27ee9\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_7571313 elementor-col-50\">\n\t\t\t\t\t<label for=\"form-field-field_7571313\" class=\"elementor-field-label\">Times you plan to pick up your child :<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_7571313]\" id=\"form-field-field_7571313\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_1fb3ca6 elementor-col-100\">\n\t\t\t\t\tCHILD'S HEALTH RECORD: (A copy of your child's immunizations and current physical will be needed)\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_b6237a4 elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_b6237a4\" class=\"elementor-field-label\">General state of health:<\/label><textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_b6237a4]\" id=\"form-field-field_b6237a4\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_d9956d4 elementor-col-70\">\n\t\t\t\t\t<label for=\"form-field-field_d9956d4\" class=\"elementor-field-label\">Doctor\u2019s name<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_d9956d4]\" id=\"form-field-field_d9956d4\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_9bb0664 elementor-col-30\">\n\t\t\t\t\t<label for=\"form-field-field_9bb0664\" class=\"elementor-field-label\">Doctor\u2019s phone number<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_9bb0664]\" id=\"form-field-field_9bb0664\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_b59cec2 elementor-col-70\">\n\t\t\t\t\t<label for=\"form-field-field_b59cec2\" class=\"elementor-field-label\">Dentists\u2019 name <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_b59cec2]\" id=\"form-field-field_b59cec2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_cb4376c elementor-col-30\">\n\t\t\t\t\t<label for=\"form-field-field_cb4376c\" class=\"elementor-field-label\">Dentist's phone number<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_cb4376c]\" id=\"form-field-field_cb4376c\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_17bf007 elementor-col-100\">\n\t\t\t\t\tAre your child's immunizations up to date? (Please attach a copy of immunizations. This should include the signature of nurse or doctor who administered medications.)\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group- elementor-col-20\">\n\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper \">\n\t\t\t<select name=\"form_fields[]\" id=\"form-field-\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t<option type=\"checkbox\" value=\"Monday Yes\" id=\"form-field--0\" name=\"form_fields[][]\">Yes<\/option><option type=\"checkbox\" value=\"Tuesday No\" id=\"form-field--1\" name=\"form_fields[][]\">No<\/option>\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_d222359 elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_d222359\" class=\"elementor-field-label\">Does your child have any known allergies?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_d222359]\" id=\"form-field-field_d222359\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_0d45c27 elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_0d45c27\" class=\"elementor-field-label\">Are you concerned that your child may be prone to any type of allergies? \t Describe:<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_0d45c27]\" id=\"form-field-field_0d45c27\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_b2288ed elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_b2288ed\" class=\"elementor-field-label\">Does your child have any medical conditions which I should be made aware of?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_b2288ed]\" id=\"form-field-field_b2288ed\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_3bde790 elementor-col-66\">\n\t\t\t\t\tHas your child had the following common childhood illnesses? Does your child have any problems with\nany of these?\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_186e892 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Constipation\" id=\"form-field-field_186e892-0\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-0\">Constipation<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Convulsions\" id=\"form-field-field_186e892-1\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-1\">Convulsions<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Diarrhea\" id=\"form-field-field_186e892-2\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-2\">Diarrhea<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Fainting Spells\" id=\"form-field-field_186e892-3\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-3\">Fainting Spells<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Frequent Colds\" id=\"form-field-field_186e892-4\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-4\">Frequent Colds<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Frequent Ear Infections\" id=\"form-field-field_186e892-5\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-5\">Frequent Ear Infections<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Frequent Sore Throats\" id=\"form-field-field_186e892-6\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-6\">Frequent Sore Throats<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Lice\" id=\"form-field-field_186e892-7\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-7\">Lice<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Ringworm\" id=\"form-field-field_186e892-8\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-8\">Ringworm<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Skin Rash\" id=\"form-field-field_186e892-9\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-9\">Skin Rash<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Soiling\" id=\"form-field-field_186e892-10\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-10\">Soiling<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Stomach Upsets\" id=\"form-field-field_186e892-11\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-11\">Stomach Upsets<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Urinary Problem\" id=\"form-field-field_186e892-12\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-12\">Urinary Problem<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Worms\" id=\"form-field-field_186e892-13\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-13\">Worms<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"\" id=\"form-field-field_186e892-14\" name=\"form_fields[field_186e892]\"> <label for=\"form-field-field_186e892-14\"><\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_d1819de elementor-col-100\">\n\t\t\t\t\tHas your child had any of these diseases?\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_8e2dc48 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Asthma\" id=\"form-field-field_8e2dc48-0\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-0\">Asthma<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Bronchitis\" id=\"form-field-field_8e2dc48-1\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-1\">Bronchitis<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Chicken Pox\" id=\"form-field-field_8e2dc48-2\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-2\">Chicken Pox<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Diabetes\" id=\"form-field-field_8e2dc48-3\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-3\">Diabetes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Heart Disease\" id=\"form-field-field_8e2dc48-4\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-4\">Heart Disease<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Hepatitis\" id=\"form-field-field_8e2dc48-5\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-5\">Hepatitis<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Impetigo\" id=\"form-field-field_8e2dc48-6\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-6\">Impetigo<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Measles\" id=\"form-field-field_8e2dc48-7\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-7\">Measles<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Mumps\" id=\"form-field-field_8e2dc48-8\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-8\">Mumps<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"German Measles\" id=\"form-field-field_8e2dc48-9\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-9\">German Measles<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Polio\" id=\"form-field-field_8e2dc48-10\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-10\">Polio<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Scarlet Fever\" id=\"form-field-field_8e2dc48-11\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-11\">Scarlet Fever<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Tuberculosis\" id=\"form-field-field_8e2dc48-12\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-12\">Tuberculosis<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Whooping Cough\" id=\"form-field-field_8e2dc48-13\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-13\">Whooping Cough<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"\" id=\"form-field-field_8e2dc48-14\" name=\"form_fields[field_8e2dc48]\"> <label for=\"form-field-field_8e2dc48-14\"><\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_df22610 elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_df22610\" class=\"elementor-field-label\">Does your child have any speech, hearing or visual problems?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_df22610]\" id=\"form-field-field_df22610\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_a4793d7 elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_a4793d7\" class=\"elementor-field-label\">Would there be any restrictions to play or activities?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_a4793d7]\" id=\"form-field-field_a4793d7\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_0432e7f elementor-col-100\">\n\t\t\t\t\tAbout Your Child:\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_df24c82 elementor-col-30\">\n\t\t\t\t\t<label for=\"form-field-field_df24c82\" class=\"elementor-field-label\">Has your child ever been in child care before?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_df24c82]\" id=\"form-field-field_df24c82\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_e8d8726 elementor-col-33\">\n\t\t\t\t\t<label for=\"form-field-field_e8d8726\" class=\"elementor-field-label\">What type (center, family daycare, grandma etc.) <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_e8d8726]\" id=\"form-field-field_e8d8726\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_028f266 elementor-col-30\">\n\t\t\t\t\t<label for=\"form-field-field_028f266\" class=\"elementor-field-label\">Was it a positive experience? <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_028f266]\" id=\"form-field-field_028f266\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_27903b9 elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_27903b9\" class=\"elementor-field-label\">Why are you looking for child care? <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_27903b9]\" id=\"form-field-field_27903b9\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_6f85489 elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_6f85489\" class=\"elementor-field-label\">How does your child feel about daycare and being left by his\/her mommy\/daddy?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_6f85489]\" id=\"form-field-field_6f85489\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_1f4ee4a elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_1f4ee4a\" class=\"elementor-field-label\">Are there any recent traumatic situations the child has been exposed to such as a death in the family, divorce, new sibling etc.?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_1f4ee4a]\" id=\"form-field-field_1f4ee4a\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_0c1eeaf elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_0c1eeaf\" class=\"elementor-field-label\">What is your normal method of discipline? <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_0c1eeaf]\" id=\"form-field-field_0c1eeaf\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_494668b elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_494668b\" class=\"elementor-field-label\">What is your child's temperament? Are they easy going, hard to please, demanding, aggressive, etc.<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_494668b]\" id=\"form-field-field_494668b\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_332340e elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_332340e\" class=\"elementor-field-label\">Are there any food restrictions? <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_332340e]\" id=\"form-field-field_332340e\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_bf6beb8 elementor-col-50\">\n\t\t\t\t\t<label for=\"form-field-field_bf6beb8\" class=\"elementor-field-label\">What is your child's favorite food?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_bf6beb8]\" id=\"form-field-field_bf6beb8\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_f460ce3 elementor-col-50\">\n\t\t\t\t\t<label for=\"form-field-field_f460ce3\" class=\"elementor-field-label\">What food does your child dislike?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_f460ce3]\" id=\"form-field-field_f460ce3\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_a1c2e00 elementor-col-50\">\n\t\t\t\t\t<label for=\"form-field-field_a1c2e00\" class=\"elementor-field-label\">Can your child be relied upon to indicate bathroom wishes?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_a1c2e00]\" id=\"form-field-field_a1c2e00\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_a68807e elementor-col-50\">\n\t\t\t\t\t<label for=\"form-field-field_a68807e\" class=\"elementor-field-label\">What words does your child use for: Bowel movements  \t urination <\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_a68807e]\" id=\"form-field-field_a68807e\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_24a6d64 elementor-col-50\">\n\t\t\t\t\t<label for=\"form-field-field_24a6d64\" class=\"elementor-field-label\">What time does your child awaken?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_24a6d64]\" id=\"form-field-field_24a6d64\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_c55c948 elementor-col-50\">\n\t\t\t\t\t<label for=\"form-field-field_c55c948\" class=\"elementor-field-label\">What time does your child go to sleep at night?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_c55c948]\" id=\"form-field-field_c55c948\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_0d12d7d elementor-col-50\">\n\t\t\t\t\t<label for=\"form-field-field_0d12d7d\" class=\"elementor-field-label\">Do they sleep through the night?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_0d12d7d]\" id=\"form-field-field_0d12d7d\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_96ee80b elementor-col-50\">\n\t\t\t\t\t<label for=\"form-field-field_96ee80b\" class=\"elementor-field-label\">Does your child sleep in a bed or crib, other?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_96ee80b]\" id=\"form-field-field_96ee80b\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_f9cdfa0 elementor-col-100\">\n\t\t\t\t\tAre there any siblings? Please name them and specify ages and gender.\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_2602447 elementor-col-40\">\n\t\t\t\t\t<label for=\"form-field-field_2602447\" class=\"elementor-field-label\">Name:<\/label><textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_2602447]\" id=\"form-field-field_2602447\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_690b695 elementor-col-30\">\n\t\t\t\t\t<label for=\"form-field-field_690b695\" class=\"elementor-field-label\">Age:<\/label><textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_690b695]\" id=\"form-field-field_690b695\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_db5ceb2 elementor-col-30\">\n\t\t\t\t\t<label for=\"form-field-field_db5ceb2\" class=\"elementor-field-label\">Gender:<\/label><textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_db5ceb2]\" id=\"form-field-field_db5ceb2\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_565d4da elementor-col-50\">\n\t\t\t\t\t<label for=\"form-field-field_565d4da\" class=\"elementor-field-label\">Has your child had experience playing with other children?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_565d4da]\" id=\"form-field-field_565d4da\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_b3b6ad0 elementor-col-50\">\n\t\t\t\t\t<label for=\"form-field-field_b3b6ad0\" class=\"elementor-field-label\">What language(s) are spoken at home?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_b3b6ad0]\" id=\"form-field-field_b3b6ad0\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_9d6eab5 elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_9d6eab5\" class=\"elementor-field-label\">Does your child have any security objects such as a blanket, soother, bottle, toy etc. ?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_9d6eab5]\" id=\"form-field-field_9d6eab5\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_92af88c elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_92af88c\" class=\"elementor-field-label\">What are your child's favorite activities, toys, books, or games?<\/label><input size=\"1\" type=\"text\" name=\"form_fields[field_92af88c]\" id=\"form-field-field_92af88c\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_d10559b elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_d10559b\" class=\"elementor-field-label\">Are there any other comments or information you would like to let me know about?<\/label><textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_d10559b]\" id=\"form-field-field_d10559b\" rows=\"3\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_d668632 elementor-col-100\">\n\t\t\t\t\t<label for=\"form-field-field_d668632\" class=\"elementor-field-label\">Any specific concerns? <\/label><textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_d668632]\" id=\"form-field-field_d668632\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button type=\"submit\" class=\"elementor-button elementor-size-sm\">\n\t\t\t\t\t\t<span >\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\" elementor-button-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Send<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Enrollment Form<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_canvas","meta":{"footnotes":""},"class_list":["post-1192","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/funtimelearningcenterinc.com\/index.php\/wp-json\/wp\/v2\/pages\/1192","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/funtimelearningcenterinc.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/funtimelearningcenterinc.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/funtimelearningcenterinc.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/funtimelearningcenterinc.com\/index.php\/wp-json\/wp\/v2\/comments?post=1192"}],"version-history":[{"count":96,"href":"https:\/\/funtimelearningcenterinc.com\/index.php\/wp-json\/wp\/v2\/pages\/1192\/revisions"}],"predecessor-version":[{"id":1458,"href":"https:\/\/funtimelearningcenterinc.com\/index.php\/wp-json\/wp\/v2\/pages\/1192\/revisions\/1458"}],"wp:attachment":[{"href":"https:\/\/funtimelearningcenterinc.com\/index.php\/wp-json\/wp\/v2\/media?parent=1192"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}