* Required Information
Little Magic Moments Academy
  • 6531 GERMANTOWN AVENUE
  • PHILADELPHIA, PA. 19119
  • (215)842-1101

  • COVID-19 PUBLIC HEALTH EMERGENCY
  • SPECIAL PROGRAM ATTENDANCE
  • ACKNOWLEDGEMENT AND DISCLOSURE

1. I understand that during this COVID-19 Public Health Emergency I will NOT be permitted to enter the facility beyond the designated drop-off and pick-up area. I understand that this procedure changes is for the safety of all persons present in the facility and to limit, to the extent possible everyone's risk of exposure. I understand that it is my responsiblity to inform any emergency contact and release persons of the information contained herein

2. I understand that IF there is an emergency requiring me to enter the facility beyond the designated drop-off and pick-up area I MUST wash my hands before entering, remove my shoes/or cover my shoes and wear a mask. While in the facility I must practice social distancing and remain 6ft from all other people, except for my own child. The center will provide mask, gloves, hand sanitizer and shoe covers at the designated drop-off and pick-up area.

3. I undestand that drop-off and pick-up times for children will be staggered as to prevent too many parents dropping off at the same time. Please stick to your drop-off and pick up time. Please make arrangements with management ahead of time if you need to change it.

4. I understand that I must limit the number of people picking up and dropping off my child to just the two primary caregivers of the child. If an emergency occurs and the primary caregivers are not available to do so I will notify management ASAP.

5. I understand that to enter upon the facility premises my child must be free from (COVID -19) symptoms. If, during the day, any of the following symptoms appear my child will be put into the sick child area. I will be contacted, and my child MUST be picked up from the facility within 30 minuest of being notified


  • fever of 100.4 degrees Fahrenheit or higher
  • dry cough
  • Shortness of Breath
  • Chills
  • Loss of taste or smell
  • Sore Throat
  • Muscle aches

While we understand that many of these symptoms can also be related to non-COVID-19 related issues we must proceed with an abundance of caution during this Public Health Emergency. These symptoms typically appear 2-7 days after being infected so please take them seriously. Your child will need to be symptom free without any medications for 48 hours before returning to the facility.

6. I understand that my child's temperature will be taken upon arrival at the center and as needed thoughout the day while on facility premises

7. I understand that my child must wear a mask at all times while in the facility and on facility premises. This does not apply to children under the age of 2 years old (OPTIONAL, may be required by some states in order to operate.)

8. I understand that my child be required to wash their hands using CDC receommended hand washing procedures throughout the day using warm running water and rubbinbg with soap for at least 20 seconds.

9. I understand that I must bring my child a pair of shoes to the facility that will ONLY be worn inside this facility and will be left here each evening. I MUST remove my child's shoes at the entrance of the facility. Staff will have the child put on theirs "center only shoes" once the child washes their hands and goes into the classrom/ At pick up, Staff will remove the child's "center only shoes" and the child will be brought to the entrance where I will put on my child's outside shoes prior to leaving the facility. The children's "center only shoes" will be sanitized by staff each night.

10. I understand that outside of work, I am responsible for controlling my exposure in the community, I will comply with any and all state, country or local stay-at-home orders and will follow any recommendations from the CDC that limits my risk for exposure including wearing a mask in all public areas and remaining 6ft from all other people.

11. I will immediately notify Little Magic Moments Academy management if i become aware of any person with whom my child or I have had contact with that exhibits any of the sysmptoms listed in Number 5 above, is advised to self-isolat,quarantine, or has tested positive, or is presumed positive for COVIDE-19. Further, I will immediately notify Little Magic Moments Academy management if anyone from my place of employment is presumed positive or tests positive for COVID-19 if I have had direct contact with that person

12. I understand that while present in the facility each day my child will be in contact with children, families and other employees who are also at risk of communityy exposure. I understand that no list of restrictions, guideline or practices will remove 100% of the risk of exposure to COVID-19 as the virus can be transmitted by persons who are asymptomatic and before some people show signs of infection. I understand that I play a crucial role in keeping everyone in the facility safe and reducing the risk of exposure by following the practices outline herein.

Also, we have temporarily removed the morning cut-off time of 9:30am. WE understand that in this COVID19 economy that work situations, responsibilities and shifts are ever changing. We ask that you be considerate of the other students and staff that are working and learning and bring your child in at a reasonable time. If you bring your child to the center after 9:30am breakfast will be over and you will be responsible for providing them with this meal prior to drop-off.

I, certify that I have read, understand, and agree to comply with the provisions listed herein. I acknowledge that failure to act in accordance with the provisions listed herein, or with any other policy or procedure outlined by Little Magic Moments Academy will result in termination of services. I acknowledge that care for my child will be terminated if it is determined that my actions, or lack of action unnecessarily exposes another employee, child, or their family member to COVID-19.

By submitting this form you agree to the terms of the Privacy Policy.

Select a country first.