Enrollment Infants Welcome

ENROLLMENT — INFANTS WELCOME

This Enrollment Agreement establishes the terms under which the named child is enrolled in the Infants Welcome program. The program provider reserves the right to enforce published policies and to terminate services for nonpayment or breach of policies. Parent/Guardian certifies that the information below is true and authorizes emergency medical treatment as indicated.

Student Information

Parent / Guardian Information

Enrollment & Attendance Details

Program Track:

Requested Start Date:

Emergency Contacts & Medical Information

I certify that the child's immunizations are up to date in accordance with applicable public health requirements.

My child has a documented exemption from immunizations. I will provide required exemption documentation to the program.

Permissions & Operational Consents

Diapering and toileting care: I authorize staff to perform diapering and toileting care as needed.

Medication administration: I authorize staff to administer prescription medication in accordance with written instructions and program policy. All medications must be in original labeled containers and accompanied by an authorization form.

Photography and observation: I grant permission for photographs or observations of my child to be used for program records, classroom communication, or promotional materials.

I do NOT grant permission for photographs of my child to be used beyond internal records.

Emergency Authorization & Liability

In the event of an emergency requiring medical attention, and if the parent/guardian cannot be reached, I authorize the program to obtain emergency medical treatment for my child and to transport the child to a medical facility if necessary. I understand I am responsible for all costs of emergency care and transportation.

I agree that the program is not liable for injuries resulting from activities that are part of normal child care when staff have exercised reasonable care, nor for incidents resulting from the parent's failure to disclose medical or behavioral history. This agreement does not waive any claim that cannot be waived as a matter of law.

Payment, Termination & Policies

Enrollment is confirmed upon acceptance and receipt of any required deposit. Tuition is due according to the payment plan above. Late payment may result in late fees, suspension of enrollment, or termination of services. Withdrawal requires written notice provided at least the period required by program policy; failure to provide timely notice may result in forfeiture of a deposit or continued tuition liability as set forth in program policies.

I acknowledge that I have received, reviewed, and agree to abide by the program's written policies regarding health, safety, pick-up, and behavior management as provided at enrollment. Failure to comply with those policies may result in termination of services.

I certify under penalty of perjury that the information provided on this form is complete and accurate to the best of my knowledge.

I acknowledge and accept the terms, consents, and policies contained in this enrollment agreement.

Additional Information

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