enrollment packet preschool

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Page 1: Enrollment packet   preschool
Page 2: Enrollment packet   preschool
Page 3: Enrollment packet   preschool
Page 4: Enrollment packet   preschool
Page 5: Enrollment packet   preschool
Page 6: Enrollment packet   preschool

Authorization and Permission Form for _______________________ (child’s name)I/We _____________________________________________, hereby grant permission to Yasmeen Nasira and Alina Mendoza of Alif-Ba-Ta Learning Center to provide the following activities for our child by initialing & 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 parent’s 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. Initial toApprove

Initial to Deny

I/We give permission for my child to participate in each of the following activities for 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 TelevisionB VideoC Gaming systems (Educational Only)D Computer

I/We _______________________________________________, authorize Yasmeen Nasira and Alina Mendoza of Alif-Ba-Ta Learning Center to call a doctor, 911, or an ambulance for medical or surgical care for my/our child __________________________________ (child’s name), should an emergency arise. It is understood that a conscientious effort will be made to locate the parents/guardians before emergency action will be taken, but if this is not possible, the expenses of emergency medical treatment or care will be accepted by the parents/guardians. Notarization is required annually to provide the childcare provider with authorization to give medical authorization to emergency/health professionals:

_______________________________________ _____________________Parent/Guardian Date_______________________________________ _____________________Parent/Guardian Date Subscribed and affirmed before me this ____________ day of ___________, 20__, in the County of __________________________, State of Colorado.

______________________________________Notary Public

My Commission Expires: _____________________________

Page 7: Enrollment packet   preschool

Child Release Authorization

I understand that every effort will be made to contact me. In the event the staff is unable to reach me I authorize the following designate(s) to pick up my child. I understand designate(s) must be over the age of 18 years and have a valid state issued driver’s license and an age appropriate vehicle child restraint. I will instruct my designate(s) to bring their I.D. with them each time they are needed to pick up my child. I also understand that any additions to my Child Release form must be done in writing prior to needing a new addition to pick my child up. I understand without written consent the provider cannot release my child to another person not listed.

Child’s name: ________________________________________ DOB: _________________________

The following persons are authorized to pick up my child:

1st PersonName: Relationship:Address: Work/Home Phone:City/Zip: Alternate Contact:

2nd PersonName: Relationship:Address: Work/Home Phone:City/Zip: Alternate Contact:

3rd PersonName: Relationship:Address: Work/Home Phone:City/Zip: Alternate Contact:

4th PersonName: Relationship:Address: Work/Home Phone:City/Zip: Alternate Contact:

5th PersonName: Relationship:Address: Work/Home Phone:City/Zip: Alternate Contact:

_________________________________ _______________________________ Parent/Guardian signature Date

_________________________________ _______________________________ Parent/Guardian signature Date

Page 8: Enrollment packet   preschool

PERMISSION TO PHOTOGRAPH FORM

I, ________________________________________________________________________________________ (parent’s or guardian’s name)

give permission for Alif-Ba-Ta Learning Center

to photograph my child/ren, _____________________________________________________________ (child’s name)

for the following purposes:

Type of Use:(Please check one)

Grant Permission Decline Permission

Still Photographs:Display in preschool’s scrapbook or bulletin boards, shown to current and prospective familiesDisplay still photos on center’s website *Use still photos in promotional materials

Videos:Display video on facility websiteUse videos in promotional materials

Other (please list):

* 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 child’s 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/Guardian’s Signature Date

Mother/Guardian’s Signature Date

Alif-Ba-Ta Learning Center Date

Page 9: Enrollment packet   preschool

P

PERMISSION TO TRANSPORT AND FIELDTRIPS

I HEREBY GRANT MY PRESCHOOL PROVIDER PERMISSION TO TRANSPORT MY CHILD IN LICENSED INSURED VEHICLES, USING FEDERAL APPROVED CHILD SAFETY SEATS AND BELTS ACCORDING 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 THAT WILL NEED TO BE SIGNED WITH THE DETAILS OF THE FIELDTRIP, INCLUDING: DATE, TIME, LOCATION, AND COST.

PARENTS SIGNATURE

______________________________________ Date_________

PROVIDER SIGNATURE

______________________________________ Date_________