with locations in Tolland and Ellington
860-559-1545
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Early Beginnings Registration Form

Please fill out the form below.

ALL INFORMATION IS REQUIRED. FAILURE TO FILL OUT ALL FIELDS WILL RESULT IN HAVING TO START OVER.
Child's Name: * Nickname:
Male Female
Child's Address: * Town: *
Zip:
Home Phone: * Date of Birth: *
Child Lives With: Both Parents Mother Father Other  
Billing Name (if different):  
Billing Address (if different):
Father's Name: * Occupation:
Business Address: Business Phone: *
Cell: *
Mother's Name: * Occupation:
Business Address: Business Phone: *
Cell: *
Email Address: *  
How did you hear about Preschool of the Arts?
 
Payment Preference: Monthly Semi-monthly Weekly (auto check) Other

START DATE: (our program begins on August 25, 2014)


DAYS AND HOURS REQUESTED: * (indicate days/hours - example: 8:30 am - 5:30 pm)

Mon.* Tues.* Wed.* Thurs.* Fri.*

PROGRAM * (Check one)
 
Infant EB Kindergarten
Toddler Before/After Public Kindergarten
       Name of Public School:
Preschool School Age Program
       Name of Public School:
PreK  

BILLING INFORMATION
 
Unlimited Hours B/A Public K (# of hours/day)
Partial Day/Week (# of hours/day) School Age Program (# of hours/day)

Names and bith date of other children in the family

Name Date of Birth


Names and Phone Numbers of persons who may drop off or pick up your child at the preschool:
Note: These people will need to show identification before being allowed to take your child.

Name Phone


Parent/Guardian Signature


Date

Due with this application: $50.00 non-refundable registration fee. (Second child $25) This fee is paid annually.

 

MEDICAL TREATMENT FORM

In the event you cannot be reached, please provide the names and phone numbers of persons who may be called in case of illness or emergency:

Name Phone

 

Child's Physician: Phone Number:
Child's Dentist: Phone Number:

I give permission to have my child, , receive appropriate medical treatment and/or be taken to the hospital in case of an emergency.

Signature of Parent/Guardian

Date

 

WALKING PERMISSION FORM

I give my permission for my child, to go on walking field trips with his/her class. I understand that I will be given details before each trip as to where they are going, why and for how long. I will be informed of the trip at least one day in advance, and I do not need to sign before each one as this form will be acceptable. I understand that each trip will be no more than 1/2 mile from the school and that there will always be at least 2 adults with the children at all times. If I do not wish my child to go on the field trip, I need to contact the school well in advance, so other arrangements can be made.

If my child is enrolled in Kindergarten, the teacher may take my child on any walking trip near the school at any time the teacher sees fit. These trips need not be planned in advanced and the teacher will be in charge of the small class alone. Examples: lunch at the gazebo, walk at Arbor Park, library, hardware store, etc.


Signature of Parent/Guardian

Date

 

DISCIPLINE POLICY

I have received, read and discussed the Discipline Policy (bright pink form).


Signature of Parent/Guardian

Date

 

EARLY BEGINNINGS at PRESCHOOL OF THE ARTS. INC.
REQUEST FOR ADDITIONAL INFORMATION

The Early Beginnings staff strives to provide your child with the highest quality care, and this can best be accomplished by becoming more sensitive to your child’s particular needs.

Please review and complete the questions below that are applicable to your child and return this form with your school application form. Thank you, and we look forward to seeing you and your family at Early Beginnings, Preschool of the Arts.

 

1. Who has cared for your child other than you (parents)?
2. Is your child on? Formula Breast Fed Neither  
3. Do you swaddle your child? Yes No
4. Do we have permission to swadle your child? Yes No
5. Are there any medical concerns or allergies of which we should be aware? Yes No If so, please explain:
6. Is your child afraid of any sounds, such as load whistles, sirens, or thunderstorms? Yes No If so, please explain:
7. Does your child frequently put any toys or objects in his/her mouth? Yes No  
8. Do you have any bathroom routines established with your child? Yes No If so, please explain:
9. What are your childs eating habits?
10. How long does your child typically nap and at what times?
11. How does your child adjust to transitions?
12. Does your child suffer from separation anxiety? Yes No
13. What interests does your child have? (ex. trains, Dora, zoo animals, etc.)

Please add any additional information that will help us care for your child in the best way we can.

Signature of Parent/Guardian

Date
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