Child's Name *

First Name

Last Name

I have read and have access to the information provided in the Parent Handbook. *

Please check boxes below

Information to Parents Document

Expulsion Policy

Policy on the Use of Technology and Social Media

Policy on Communicable Diseases

Policy on the Release of Children

Policy on Methods of Parental Notification

Health and Safety Resources

Tuition and Refund Policy

I understand that for the school's Grow NJ Kids accreditation, each child is required to have hearing, vision and dental screenings completed by a pediatrician or other practitioner. I agree to have these screenings documented in the "Preventative Health Screenings" section of the Universal Health form. (For more information see the "Health and Safety Resources" section of the Parent Handbook.) *

Electronic Signature

First Name

Last Name

Sharing Contact Information *

I wish to share my contact info with:

My child's class

My child's age level

Photo and Video Permission (check your preferences below) *

I give my permission for my child's image to be included in the following. Names will not be used.

Individual child images

Groups Involving my child

Facebook

Website/publicity

Electronic Signature of Parent or Legal Guardian *

Please confirm your permissions.

First Name

Last Name

School Bag *

My child is new to the school and needs a bag.

My child is returning to the school and I DO WANT a new bag.

My child is returning to the school and I DO NOT WANT a new bag.

Child's Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Main Phone *

(###)

###

####

Emergency Medical Authorization Electronic Signature *

In the event I cannot be reached, I hereby authorize the WRC Nursery School Director or teacher in charge to take my child to a hospital for emergency treatment. I understand that I am responsible for all medical costs incurred with regard to examinations and medical services rendered. In case of emergency, I give permission for the staff at the WRC Nursery School/WRC, certified in CPR/First Aid by the American Heart Association, to administer CPR/First Aid to my child until medical personnel arrive at the school.

First Name

Last Name

Child's Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

My child enjoys... *

Books

Music

Pretend Play

Media Time (tv, computer, IPad etc.)

Outdoor Play

Arts and Crafts

Being in Nature

Games

Organized Classes (music, gym, sports, dance, etc.)