2018-2019 parent handbook and Permissions

2018-19 Parent handbook

Required Signatures

Please complete the below areas and give permission by completing your electronic signature below.

Child's Name *
Child's Name
I have read and have access to the information provided in the Parent Handbook. *
Please check boxes below
I understand that for the school's Grown 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.) *
I understand that for the school's Grown 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
The ASQ-3 (3rd edition) will be distributed for completion in October and April.
Each enrolled child receives a WRC Nursery School bag to hold their belongings on the picket fences outside of the classrooms.
I wish to be included in the Family Directory
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.
I give permission for my child to walk around the church property with appropriate supervision and to walk further if needed for evacuation.
Electronic Signature of Parent or Legal Guardian *
Electronic Signature of Parent or Legal Guardian
Please confirm your permissions.

Medical Emergency Information

Child's Name *
Child's Name
Date of Birth *
Date of Birth
Street, City, State, Zip
Main Phone *
Main Phone
Name/Cell Phone
Occupation/Employer Name/Employer Address/Employer Phone
Name/Cell Phone
Occupation/Employer Name/Employer Address/Employer Phone
Name/Phone Number/Relation to Child
Name/Phone Number/Relation to Child
Name/Phone Number/Relation to Child
Name/Phone Number/Relation to Child
Pediatrician Name/Address/Phone Number
Insurance Carrier Name/Policy Number
Emergency Medical Authorization Electronic Signature *
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.

student background Information

Child's Name *
Child's Name
Date of Birth *
Date of Birth
My child enjoys... *