Form

HOURS OF OPERATION

iCare Connect Child Development Center 5832 Lee Rd South (Maple Hts.)
Monday - Friday: 6:00am - 6:00pm (Daytime Care)

iCare Connect 5065 Northfield Rd (Bedford.)
Monday - Friday: 6:00am - 6:00pm (Daytime Care) (Coming Soon)

iCare Connect Educational Academy
468 Richmond Road (Richmond Hts.)
Monday - Friday: 6:00am - 6:00pm (Daytime Care)

iCare@Nite 5824 Lee Road South (Maple Hts.)
Monday - Friday: 6:00am - 6:00pm (Daytime Childcare)
Monday - Friday: 6:00pm - 1:00am (Nite Care)
Saturday: 6:00am - 1:00am (Weekend Care)
Sunday: 6:00am - 4:00pm (Weekend Care)

*iDrop Flex Care available at all locations (ages 3 and up; must be potty trained)

https://icc4kids.org/
Instagram: @icare_connect

Welcome to iCare Connect! Please fill out the information below so we can better assist you. You can always call or text (216)769-5737 for an immediate response.

You can attend two different daycare facilities using your same current voucher. You can have two different daycares on 1 voucher, day shift, nights, weekends or camp.

(216)769-KIDS (5437)

Caretaker(s)/ Parent(s) Full Name

Parent's Email

What is a cell phone number that you can receive a text message from iCare Connect?
*

By submitting this contact form, you consent to receive text messages regarding your request from our company (iCare Connect Educational Academy) via text message/SMS. Message and data rates may apply. Message frequency may vary. To end messaging from us, you may always reply with STOP. You may also reply with HELP for more information.

https://icc4kids.org/term-of-services

https://icc4kids.org/privacy-policy

Consent to receive messages *

Children First Name*

Children Last Name*

Child Age

What is the best time to call?*

Morning 9am-11am

Afternoon 12pm-5pm

Evening 5pm-8pm

Weekends 10am-3pm

Other:

How many children would you to enroll?*

Please include All Child(ren) Birthday (MM/DD/YYYY?*

What is your desired start date?*

iCare Connect is a digital center what email address that we can email your enrollment documents to?*

Choose a Location*

iCare Connect ( Maple Hts.) ( Daytime care only)

iCare Connect Educational Academy (Richmond Hts.) (All shifts)

iCare@Nite ( Maple Hts) (Nights & Weekend care only)

iCare Connect (Bedford Heights) (COMING SOON)

Accommodate Scheduled Time*

(MORNINGS) Monday - Friday (Daily morning cut off time 9:15am)

(EVENINGS) Monday - Friday (starting at 3pm-6pm)

(NIGHTS) Monday - Friday (starting at 6pm- 1am)

Saturday (see hours of operation listed above per location)

Sunday (see hours of operation listed above per location)

Requesting special accommodations or rotating shifts

Other:

iDrop Flex Care*

iDrop Flex Care $70 (10 hrs. per shift, monthly fee $35, must be 3 yrs. old & potty trained)

iDrop Flex Additional Care (after 10 hours it's an additional $40 per every 2 hours)

N/A

CAMP

Summer Camp ( M-F 8:30am - 4:30pm (Jun-Aug) (ages 6-12) voucher or $250 per week. field trip not included $350.00

We are a schedule center. What is your desired drop off and pick up time for your child(ren)? Please type in your scheduled drop off and pick up time that includes your travel time with traffic and weather. What time will you be dropping off and picking up your child, we must staff according to staff/child ratio. iCare Connect access late fee's 15 mins after your schedule time of pick up if you're late. (please do not enter in your work schedule).*

Potty Training Fee for Preschool*

3 years of age or older (fee is waived if you have a developmental delay must have a doctor note or after visit summary)

n/a does not apply to my child(ren)

Other:

Transportation for school-age only

Do you need transportation for your school-ager to and or from school? (elementary school must be in a 2 mile radius from iCare Connect) Do you need a special accommodation for transportation? Please let us know how we can assist you. (below in the last box)

Transportation $25 weekly per child (before & after school for school-agers only)

Does not apply

Other:

Would you like to schedule a tour? All tours are optional.

Tuesday-Thursday
12:30pm-2:30pm or 5:00pm-6:30pm
(Please include location (Maple Hts or Richmond Hts) & Time)

Yes

No tour needed ready to enroll and start my child(ren)

iCare Connect is a digital center all onboard enrollment is sent out electronically. Would you like enrollment documents sent to your email? We will send you a personal text message to your cell phone as soon as it is sent out.*

Yes

Other:

iCare Connect doesn't serve pork or beef does your child have any food allergies or meal restrictions?*

Yes

Do you required your child to not eat meat or have a plant based diet only?*

Yes

Is your child allergic to anything? example: food, pets bees, dairy.*

Yes

Does your child have emergency medication or any prescription medication? example epi-pin, inhaler, etc*

Yes

Does your child(ren) has asthma?*

Yes

iCare can assist with following plans does your child(ren) have an IEP or IFSP?*

Yes

Other:

iCare Connect can assist with some services is your child considered special needs?*

Yes

Does your child(ren) have a medical condition that iCare Connect staff need to monitor?*

Maybe

Yes

Other:

iCare Connect can assist with some services, does your child have autism?*

Yes

Maybe

Other:

iCare Connect assist with services. Does your child have developmental delays? example speech, ABA therapy, behavior health.*

Yes

Maybe

Other:

Have your child(ren) ever been expelled or dismissed for any childcare facilities.*

Yes

A nonrefundable Digital Fee payment in the amount of $35 is required before your child can start per and before we can give you access to our parent communication portal called Brightwell. A Payment text to enroll will be sent to your phone. Would you like iCare connect to send you a text link to pay and hold your child(ren) slot and approve your start date. All start dates for new enrollment starts only on Mondays. All enrollment documents must be completed before your child(ren) starts and approval start date given by iCare Connect. ODJFS can not approve your start date they only approve that the voucher payments accepted.*

Yes

After you have toured and decided to be apart of iCare connect

Ask us a question? Tell us more information? Any additional information we should about your family or childcare needs. Do you need a special accommodation for your schedule or transportation let us know and we will reach out to you shortly.
Your answer

How did you find out about us?*

Other:

Street address

Company name