Enrollment packet preschool

Download Enrollment packet   preschool

Post on 07-Nov-2014



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<ul><li> 1. Authorization and Permission Form for _______________________ (childs name)I/We _____________________________________________, hereby grant permission to Yasmeen Nasira and Alina Mendoza ofAlif-Ba-Ta Learning Center to provide the following activities for our child by initialing &amp; signing below.1. I/We hereby grant permission for our child to use all of the indoor and outdoor play equipment and to participate in all of the activities of this preschool program. ______2. I/We hereby grant permission for our child to sleep in a nap room on a bed, mat or cot provided. ______3. I/We hereby give permission for our child to leave the preschool premises under the supervision of a responsible adult for neighborhood walks and other scheduled and unscheduled excursions. Permission forms for each trip are not required. ______4. I/We understand that all field trip expenses are the parents responsibility and agree to this as it is stated in the policy statement of this preschool program. I/We also understand that if a field trip will take place that the staff will give advance notice and a separate permission form to be signed with the details of the trip. I also understand that if I choose for my child not to attend, that it is my responsibility to find alternate care for that day without tuition reimbursement from the center for the fieldtrip. ______5. I/We give permission for our child to have sunscreen applied on exposed skin areas before going outside on sunny days. Sunscreen is supplied by the parent/staff and applied per stated in the health policies handbook. ______6. I/We give permission for over the counter products and topical to be used on our child for preventative purposes including but not limited to skin lotion, diaper cream/ointments, Orajel, Neosporin, Chapstick, or ___________ and ______________.7. Parents will keep the provider informed of the foods being introduced. ______8. I/We give permission to work on potty-training my child once they are determined ready for this process. I understand that a child seat will be used on a regular toilet if needed. ______ 11. Initialto InitialtoDeny I/We give permission for my child to participate in each of the following activities for Approve no more than 2 hours each day. All media programs contain age-appropriate content (G or PG ratings) and will not contain violence, profanity or other inappropriate content. A Television B Video C Gamingsystems (EducationalOnly) D ComputerI/We _______________________________________________, authorize Yasmeen Nasira and Alina Mendoza ofAlif-Ba-Ta Learning Center to call a doctor, 911, or an ambulance for medical or surgical care for my/our child__________________________________ (childs name), should an emergency arise. It is understood that a conscientiouseffort will be made to locate the parents/guardians before emergency action will be taken, but if this is not possible, theexpenses of emergency medical treatment or care will be accepted by the parents/guardians. Notarization is required annuallyto provide the childcare provider with authorization to give medical authorization to emergency/health professionals:_______________________________________ _____________________Parent/Guardian Date_______________________________________ _____________________Parent/Guardian DateSubscribed and affirmed before me this ____________ day of ___________, 20__, in the County of__________________________, State of Colorado.______________________________________Notary PublicMy Commission Expires: _____________________________ </li> <li> 2. Child Release AuthorizationI understand that every effort will be made to contact me. In the event the staff is unable to reach me I authorize thefollowing designate(s) to pick up my child. I understand designate(s) must be over the age of 18 years and have avalid state issued drivers license and an age appropriate vehicle child restraint. I will instruct my designate(s) tobring their I.D. with them each time they are needed to pick up my child. I also understand that any additions to myChild Release form must be done in writing prior to needing a new addition to pick my child up. I understandwithout written consent the provider cannot release my child to another person not listed.Childs name: ________________________________________ DOB: _________________________The following persons are authorized to pick up my child: 1stPerson Name: Relationship: Address: Work/Home Phone: City/Zip: AlternateContact: 2ndPerson Name: Relationship: Address: Work/Home Phone: City/Zip: AlternateContact: 3rdPerson Name: Relationship: Address: Work/Home Phone: City/Zip: AlternateContact: 4thPerson Name: Relationship: Address: Work/Home Phone: City/Zip: AlternateContact: 5thPerson Name: Relationship: Address: Work/Home Phone: City/Zip: AlternateContact:_________________________________ _______________________________ Parent/Guardian signature Date_________________________________ _______________________________ Parent/Guardian signature Date </li> <li> 3. PERMISSION TO PHOTOGRAPH FORM I, ________________________________________________________________________________________ (parents or guardians name) give permission for Alif-Ba-Ta Learning Center to photograph my child/ren, _____________________________________________________________ (childsname) for the following purposes: (Pleasecheckone) Type of Use: GrantPermission Decline PermissionStillPhotographs:Display in preschools scrapbook orbulletin boards, shown to current andprospective familiesDisplay still photos on centers website *Use still photos in promotional materialsVideos:Display video on facility websiteUse videos in promotional materialsOther (pleaselist): * only first names and possibly last initials (in the event of two or more children with the same first name) will be displayed on the facility website. I understand that it is my responsibility to update this form in the event that I no longer wish to authorize one or more of the above uses. I agree that this form will remain in effect during the term of my childs enrollment. By signing below, I also agree that this is a legally binding form, and providing false information could be grounds for termination of preschool services, forfeiture of retainer, or both. Father/GuardiansSignature Date Mother/GuardiansSignature Date Alif-Ba-Ta Learning Center Date </li> <li> 4. P PERMISSION TO TRANSPORT AND FIELDTRIPSI HEREBY GRANT MY PRESCHOOL PROVIDER PERMISSION TO TRANSPORT MY CHILD INLICENSED INSURED VEHICLES, USING FEDERAL APPROVED CHILD SAFETY SEATS AND BELTSACCORDING TO FEDERAL LAWS.I UNDERSTAND THAT MY CHILD IS BEING TRANSPORTED FOR THE FOLLOWING REASON(S):Field Trips and emergency purposes.IF A FIELD TRIP IS SCHEDULED, I UNDERSTAND THAT I WILL BE GIVEN A SEPARATE FORM THATWILL NEED TO BE SIGNED WITH THE DETAILS OF THE FIELDTRIP, INCLUDING: DATE, TIME,LOCATION, AND COST.PARENTS SIGNATURE______________________________________ Date_________PROVIDER SIGNATURE______________________________________ Date_________ </li> </ul>


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