Periodic Review Form

Child's Name(Required)

Parent's Name(Required)

Center(Required)

If your child attends more than one center, please check all that apply

Mt. Lebanon Extended Day Program is required by DHS to have parents review their important information, at a six-month interval after enrollment.

Please review your child’s information (per instructions listed in each section below). Then answer the questions and/or make updates below, sign and date the form, and click submit.

If you have any questions, please contact Bethany at the MLEDP Office:412-343-1661 x110 OR kids@mledp.org

ProCare Enrollment(Required)

I have reviewed my child’s Emergency Contact and Schedule Information. All information is up to date.To review your Emergency Contact Info, log into the ProCare Parent Engage App, Select the Pencil icon at the bottom left hand corner of the screen to view your profile, View those listed as "Parents or Guardians" and those listed as "Family and Additional Authorized Pick Ups" To review your child's schedule, log into your account at myprocare.com, and click "Schedule" in the blue bar at the top of the page, and then select your child's name from the drop down menu.

I have reviewed my child's Emergency Contact and Schedule Information on myprocare.com, and I am updating their information below.Please enter any changes to your Emergency Contacts or Schedule in the box below

Emergency Contact and/or Schedule Updates (Please be sure to include Name, Address, and Phone Number for anyone you are adding to your authorized pick up list

MLEDP Contract Form(Required)

I have reviewed the MLEDP Contract and still agree to all termsA copy of your signed forms should have been emailed to you shortly after you enrolled. If you do not have that copy, the contract can be reviewed here: https://mledp.org/our-programs/school-year-care/school-year-care-registration-form

Health Care information(Required)

My Child’s Health Care Provider’s Contact Information and Health Insurance information is up to date (either the info has not changed in the past 6 months or it has been updated with MLEDP)

I am updating my child's Health Care Provider's Contact information and/or their Insurance Information belowPlease enter the updates in the box below

Doctor and/or Health Insurance Updates

Signature(Required)

Date(Required)

Closed Today: Tuesday, December 2, 2025

Closed Today: Tuesday, December 2, 2025