Carbo’s Registration

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CHILD RECORD FILE CHECKLIST

  • Master Card/ Third Party Release Form
  • Immunization
  • Birth Certificate
  • Tuition Fee Payment
  • Field Trip Form
  • Non Vehicle Field Trip Form
  • Bottle Form
  • Sun Screen Authorization
  • Water Play Release
  • Photo Release Permission Form

CHILD INFORMATION FORM
Nameyour full name
Child Name
Birth
Date
Mother Name
Father Name
Mother Address
Father Address
Mother Employer
Father Employer
Mother Employer #
Father Employer #
Mother Cellular #
Father Cellular #
Mother Home #
Father Home #
Person with whom the child lives:
Child’s Doctor:
Doctor Phone Number
Child Dentist
Dentist Phone Number
INDIVIDUALS TO CONTACT IN CASE OF AN EMERGENCY:
Emergency Phone #
Emergency Phone #
Emergency Phone #
Does your child have any food allergies?pick one!
Does your child have any other allergies?pick one!
Does your child have any dietary restrictions?pick one!
Does your child have any special needs or health concerns?pick one!
Please explain any “yes” answer here:
0 /

My child has permission to be released to the following individuals, child care facilities or transportation services inaddition to emergency contact persons listed above.(Please notify these individuals that they may be asked to show proof of identity)

1. First name and last
Relationship
2. First name and last
Relationship
3. First name and last
Relationship

I authorize the facility to secure emergency medical treatment for my child.


Parents SignatureI agree to the terms and conditions
(Sign Here)
Clear Signature
Date
PAYMENT POLICY

OPTION ONE-WEEKLY: Payment is due on Monday of each week or on first dayof the week attending the Preschool.


If payment is received after Tuesday of each week, a $20.00 late fee will becharged.


OPTION TWO-MONTHLY: Payment is due the first business day of each month oron the first day of the month attending preschool.


If received after the second business day of the month a $20.00 late fee will becharged.


Child Care Assistance Payments: All child care assistance payments must be paid outeach month.


Non-Sufficient Checks: Due to the inconvenience of NSF checks, a $50.00 fee will becharged for NSF checks. 


NOTE:To figure the monthly payment you can do the following


{Weekly amount X 52 weeks divide by 12 months = Monthly Amount)


Please circle one of the options above that best apply to your payment plan.

Child Name
TUITION PAYMENT AGREEMENT

I,____________________understand that my______________________child has been accepted atCarob’s Learning Express. | have read, understand and agree with the Policy Procedure terms. |also understand that it is my responsibility to pay tuition/fees in accordance with Carbo’sLearning Express Preschool LLC, policies.


Parent SignatureI agree to the terms and conditions
(Sign Here)
Clear Signature
Date
Printed Name
Printed Name
Director/ Director Designee
FIELD TRIP

Carbo’s Learning Express Preschool will occasionally plan educational field trips toenhance what was taught in class. Field trips also add exposure to culture and diverse* communities. Fees are collected as needed to cover transportation and admission.


Parents will receive a Field Trip Permission Form prior to each field trip. Parentsreserve the right to decline the attendance of their child on any field trip. Carbo’sLearning Express Preschool have the right to decline a child’s attendance to any field trip.

POTTY TRAININGS

It is not the responsibility of any staff member of Carbo’s Learning Express Pre Schoolto fully potty train any child. However, staff is fully ready to assist parents to helptransition a child from dependent to independent when attempting to use the toilet.The initial start need to begin at home for at least two weeks before it can beeffectively started at preschool. Starting age is typically between 2 and 3 years old.Children will be able to come to school in cotton pants/underwear after they havebeen accident free for at least two weeks in pull-ups.


Listed below are the following guidelines for potty training

  • There has to be evident by staff that the child is interested in transitioning
  • The parent is responsible for providing the staff member with the necessaryitems that works for the teachers as well as the child

EXAMPLE:

  1. Pull-ups so the child will be able to remove garment with ease
  2. Staff member will be able to properly dispose soiled Pull-up
  3.  child should always have enough items for  clean-up.

PLEASE NOTE:

No BM underwear will be left on or around the building for later pick-up. This has atendency to promote unwanted critters and smell

Parent SignatureI agree to the terms and conditions
(Sign Here)
Clear Signature
Date
Printed Name

Thank you for your cooperation.

BOTTLE AUTHORIZATION

1 give my permission for my child ———————- to hold his/her bottle while in a crib, on a mat, cot etc.

Parent Signature
Date
Printed Name
TOPICAL PRODUCTS FORM

1 give my permission for staff at Carbo’s Learning Express to apply topical productsto my child wheather the center provided or |, the parent provided the product.

Sunscreenpick one!
Insect Repelliantpick one!
Diaper Rash Ointmentpick one!
Others
THIS ONE TIME AUTHORIZATION WILL REMAIN IN EFFECT UNTIL A NEW ONE IS SIGNED.
Parent SignatureI agree to the terms and conditions
(Sign Here)
Clear Signature
Date
Printed Name
NON-VEHICULAR EXCURSION AUTHORIZATION FORM

My Child  ——————————————- has Has my permissionto participate in the following off- site activities when the children are walking and accompanied by staff of the center. 

Type of Activity
Location Of Activity
Parent Signature
Date
Printed Name
PHOTO RELEASE PERMISSION

I GIVE MY PERMISSION FOR Carbo’s Learning Express Preschool LLC. To releasephotos, recordings of my child to appropriate sources.

Date of Release
Name of Source
Child’s Name
Parents SignatureI agree to the terms and conditions
(Sign Here)
Clear Signature
Date
Printed Name
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