Verification Form

Zion Lutheran Early Childhood Center

ECC Verification Form

Student Name

Please initial the statements below to confirm receipt of each of the following documents and to give concent (if so desired) for the sharing of contact information, social media release & statement of faith, then sign at the bottom of the page.

Parent Handbook/Social Media

My initials here confirm that I have read and understand the policies and procedures outlined in the current Zion Luthjeran Early Childhood Center Parent Handbook, including Billing and Payment policies. I confirm that I have read and understand the Photo Publicity Release statement in the handbook.

Zion Lutheran ECC Statement of Faith

My inititals confirm that I have received, read and signed the Statement of Faith for ZionLutheran Early Childhood Center that is available in the packet or in the Parent Handbook

Family Directory Consent/Privacy Act Statement

My initials here confirm that I give my permission for my contact information included in the current ECC Family Directory. I have read the parent/student act in the handbook.

Permission to Participate in Special Cooking Activities

My initials her confirm that I give my permission for my child to participate in cooking activities at Zion and I have notified the ECC of any allergies or for my child.

Parent/Guardian Signature

Clear

date

Date