Kindergarten Enrollment Packet

KINDERGARTEN ENROLLMENT PACKET

Student Information

Student Full Legal Name:

Date of Birth:    Student ID (if assigned):

Primary Language Spoken at Home:    Gender:

Parent / Guardian Information

Relationship to Student:    Employer:

Relationship to Student:    Work Phone:

Emergency Contacts & Authorized Pickup

Emergency Contact 1: Name: Relationship: Phone:

Emergency Contact 2: Name: Relationship: Phone:

Medical Information

Immunization Status: Up to date (records attached) Exemption on file Will provide records within 30 days

Consents and Permissions

Field Trip Permission: I consent to my child participating in supervised off-campus field trips. I do not consent to field trips.

Photo/Video Release: I authorize use of my child's image in school publications and media. I do not authorize photography/video of my child.

Emergency Medical Treatment Authorization: If I cannot be reached, I authorize school personnel to obtain emergency medical treatment for my child.

Administration of Medication: I authorize designated school personnel to administer medication per school policy and physician instructions.

Walking/On-Campus Excursions: I consent to my child participating in supervised on-campus walking excursions (playground, assembly, neighborhood walks).

Enrollment Details & Financial Agreement

Program Selected: Half-day kindergarten Full-day kindergarten

Expected Start Date:

Payment Plan: Monthly Per semester Annual

Registration Fee (non-refundable):

By enrolling, the undersigned agrees to pay tuition and fees in accordance with school billing procedures. Refunds are governed by school policy; late payments may incur penalties or suspension of attendance until current.

Records, Documents & Residency

Previous School Name (if applicable):

Dates Attended: From to

Proof of Age (select documents provided): Birth certificate Passport Other government ID

Proof of Residency Provided: Utility bill Lease/mortgage Other

Policies, Acknowledgements & Certification

Attendance & Conduct Acknowledgment: I acknowledge the school's attendance and student conduct policies, and I agree to support school staff in enforcing rules necessary for student safety and welfare. I understand that chronic unexcused absence or serious disciplinary infractions may affect continued enrollment.

Privacy & Records: I authorize release of educational records necessary for enrollment and certify that all information provided on this form is true and complete to the best of my knowledge. I understand false statements may be grounds for denial or rescission of enrollment.

Liability & Transportation: For approved field trips, I authorize my child to participate and acknowledge the school will exercise reasonable care. I agree that the school is not liable for injury arising from activities except for negligence or willful misconduct by school staff.

Medication and Treatment: I authorize designated school personnel to administer non-prescription first aid and prescribed medication consistent with physician instructions provided in writing. I will supply medication in original labeled containers with written directions.

Certification: I certify that the information contained in this enrollment packet is accurate and complete and that I have the legal authority to enroll this child.

Additional Information

Signature

By signing below, the undersigned acknowledges and accepts the terms of this enrollment packet, consents to the permissions checked above, and certifies that they are authorized to enroll this child and make the selections indicated.

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