Should my child become ill or suffer an accident, hereby authorize Primrose Schools to administer, call for, or secure the necessary emergency care of medical attention as deemed necessary by Primrose Schools understand that an effort will be made to contact myself or the designated persons if possible, before any action is taken. also understand that any expense incurred will be accepted by me.

* (Please indicate "none known" if applicable)

List two individuals OTHER than parents/guardians who may be contacted to pick up your child in case of an emergency. Name Relation to Child Relation to Parent

A non-refundable registration and supply fee of      the beginning of Summer Adventure Club, where applicable. This annual fee may be assessed annually or biannually as noted by the school's tuition schedule. The fee includes processing the child's application, art and school supplies, a Primrose Schools bag or backpack and T-Shirt, the child's Accident Insurance Premium, and other fees as assessed by the School. All applicable forms must be completed prior to the child's attendance. 

Applicant understands the importance of and assumes responsibility for notifying the school of any significant changes in enrollment information such as work, and home phone numbers, email address, work location, emergency contacts, authorized pick- up persons, medical information, custody orders, etc.

Tuition

Your tuition payment reserves your child's space in our program. In order to ensure quality programming and high quality staffing, your tuition is due even when your child is absent. Tuition is paid monthly. If your tuition is not paid in a timely manner, a late fee of $25 will be added. Monthly tuition is due on the of the month for the upcoming month's services. Failure to stay current in your child's tuition fees may result in the loss of your child's space at Primrose Schools and will constitute a default which will entitle Primrose Schools to all remedies as prescribed by law including reasonable attorney's fees. The tuition for your child's program is due and payable regardless of weather conditions or In- -Service Days that may or may not affect the school's opening and closing.

If a child is left at school after closing, a Leadership Team Member will attempt to contact parents first, then will proceed to the listed emergency contacts to pick up the child If a child is left for an unreasonable length of time and we are unable to locate any authorized adult to care for the child, we must then contact the appropriate regulatory agency including the Department of Family and Children Services. Parents are charged a late fee of $5.00 at closing and $5.00 per minute thereafter if their children remain at school after the designated closing time. This fee is payable to the school immediately at the time their children are picked up.

If a check is returned unpaid by the bank a service charge of $25.00.

This Primrose School is open Monday through Friday, January through December. For specific times and dates of school closings, review the Parent Handbook and related Addendum.

Should it become necessary to withdraw your child for any reason, be sure you have reviewed the Withdrawal procedures in the Parent Handbook and Addendum Verbal notice will not be considered withdrawal notification.

The registering parent/guardian must notify Primrose Schools in writing of all persons authorized to pick up the child.

Parents/Guardians must complete the sign in/sign out process for their child at the front desk each day. Children must be escorted daily to and from their classroom by their parent/guardian. Parent/Guardian will be certain that the attending staff member is aware of the child's arrival and departure at school each day.

Children who become ill, or retain a temperature of 101°F or above, taken orally; or 100 degrees or higher taken under the arm, may not remain at school, nor will an ill child be admitted It is the responsibility of the parent/guardian to make arrangements to have the child picked up as soon as possible after they have been notified of a child's illness. Children who have been exposed to or have contracted serious communicable or infectious diseases may not return to school until the disease is no longer contagious, and a note from the child's physician is given to the Director.

Medication will only be administered once a day and only one medication per child, per day will be given. All medications must be signed in at the front desk. No medication may be placed in the child's tote bag. Only medication specifically labeled as a prescription with doctor's name, child's name and dosage procedures outlined will be administered "Over the Counter" medication can only be administered with written authorization from the child's physician Medication will not be administered without a signed authorization for each day given.

If the child does not live with both parents, a copy of the court-ordered custody decree must be maintained in the child's permanent school file The guidelines of the custody decree will be strictly enforced

List two individuals, OTHER than parents/guardians, who are authorized to pick up your child.

We are an Equal Opportunity Care Provider

GENERAL AUTHORIZATIONS:

PERMISSION TO LEAVE GATED AREA

Permission is hereby given for my child to leave the gated area for special reasons such as nature walks, etc. Although they may leave the gated area, they will not leave the school campus and will always be supervised. This will not involve use of transportation All actual field trips will have their own field trip permission slip, showing date, destination, time, etc.

STUDENT INTERNET USE

I authorize my child to have access to the Internet through Primrose approved pathways only. and under teacher supervision at all times. under- stand that, in spite of the precautions taken by this school, exposure to inappropriate materials may accidentally occur. I. agree to indemnify, defend and hold harmless Primrose Schools, its employees and agents, from any and all claims, demands, actions, liabilities and expenses, arising from or related to my child's use of the Internet, and hereby waive, release, and discharge, any and all claims may have against Primrose Schools and its affiliates arising from my child's use of the Internet and the use thereof by Primrose Schools' teachers, administrators, officers, employees, and other students. With that understanding, hereby give permission to Primrose Schools to allow my child to have access to the Internet under these stated conditions.

PERMISSION TO APPLY SUNSCREEN

I authorize Primrose School's staff to apply sunscreen to my child, for protection from the sun when needed each day they attend school.  I understand that 1)I am to provide sunscreen labeled with my child's name, 2) Only the sunscreenl provide will be applied to my child, and 3)U the parent/guardian, am to apply the sunscreen in the morning before school and it will be applied again by my child's teacher after the rest period in the afternoon.

Photography/ Video Release

I authorize Primrose School Franchising Company ("Primrose Schools"), its licensees and its assigns and those acting with its permission to make, reproduce, publish and otherwise use the photographs, videos, and/or sound recordings for the purposes of illustration, advertising and publicity, in any manner or in any form, including broadcast, print, electronic and social media conducted by or on behalf of Primrose Schools. waive any right that may have to inspect or approve the uses. agree to indemnify, defend and hold harmless Primrose Schools, its licensees, assigns, their employees and agents from claims arising from or relating to the use of the videotape/photograph/sound recordings of my child and hereby waive, release, and discharge any claim may have against Primrose and its licensees and assigns arising from the use of the videotape, photographs or sound recordings of my child. Primrose Schools will not identify my child without written consent.I understand that this approval may be revoked at any time by written request to the management of the Primrose School my child attends.

I hereby request Primrose, through its designated authority, to administer medication according to the above instruction.  I release the school and any school employee from any liabiltiy for administering this medication.  

I authorize Primrose School Franchising SPE, LLC and its affiliates, successors, assigns, agents, and designees (collectively, “Primrose”) to photograph, video, or otherwise record me, edit such photographs, videos, and/or sound recordings (“Recordings”) as Primrose may desire, and incorporate such Recordings into materials, including but not limited to training materials, social media, and promotional and advertising materials (collectively, “Materials”). I waive any right that I may have to inspect or approve the Materials. Primrose shall own all right, title and interest, including the copyright, in and to the Materials. Primrose may use the Materials, any portions thereof, and the Recordings in all markets, manner, formats and media, whether now known or hereafter developed, throughout the world, in perpetuity. I understand that there will be no financial or other remuneration for my appearance in the Materials. I agree to indemnify, defend and hold harmless Primrose from claims arising from or relating to the use of the Recordings and hereby waive, release, and discharge any claim I may have against Primrose arising from the use of the Recordings. I am at least 18 years of age, have the right to grant all of the rights and authorizations herein, and am competent to execute this agreement. 

I represent that I have read and understand the foregoing statements and that I will be bound by the terms of this Release.

I hereby grant the Primrose school my child attends, Primrose School Franchising Company LLC, and its affiliates, licensees, successors and those acting with its permission (collectively, “Primrose Schools”) authorization to make, reproduce, and use my child’s likeness in a photograph, video and/or sound recording (collectively, “Materials”) in any of the following ways:

I understand and agree that the Materials will become the property of Primrose Schools and will not be returned. I waive any right to review, approve or be compensated for these uses of the Materials. I further waive and release Primrose Schools from any claims and liabilities relating to the use of the Materials of my child, as set forth above.

Primrose Schools will not identify my child by name without written consent. I understand that this approval may be revoked at any time by written request to the management of the Primrose school my child attends.

Each Primrose schools has a Social Media Policies in place for its families. Pursuant to such policy, parents may not post images of Primrose children (other than their own) to their personal social media accounts.

I represent, as the parent or guardian, that I have read this release before signing below and I fully understand the contents, meaning, and impact of this release.

Setting up AutoPay through ProCare Connect is strongly encouraged. It is the simplest way to ensure on-time payment of your tuition. An invoice for your monthly tuition will be available to you on the 1st day of each month. If AutoPay is selected, the invoiced amount will automatically be deducted from the account you have chosen on the 1st of each month.

If you choose to manually make your payment each week/month through the ProCare Connect app or the ProCare Connect desktop website, payments are due by the 1st of each month or 1st business day after. Per the Application for Enrollment and the Parent Handbook Addendum, a $25.00 late payment will be applied to any payments not received by that date.

I (WE) hereby authorize Primrose School of Yukon to initiate drafts for monthly or
weekly tuition payments (late fees and other fees, if applicable) from the account on record in ProCare Connect, as set forth above. This authorization shall remain in effect as long as my child(ren) are enrolled in the school or until I (WE) provide written notice to the school that the authorization is revoked. All final tuition payments will be drafted from the account on file prior to final date of enrollment.

Program Information

Primrose School of Yukon 

725 N Mustang Rd

Yukon, OK  73099

Licesnce # K8   K83-0055348

(405)467-5100

Owner(s): Alicia Abla & Kimberly Waterman

Please list the name(s) and birth date(s) for any child(ren) you are enrolling in this program: 

I understand and am aware:

- this program is required to maintain a copy of the compliance file on-site and the information contained in the file is available for inspection.

-of the compliance file location and its contents

-this form is to be completed

-upon every child enrollment

-every 12 months thereafter

-a copy of the program specific Notice to Parents is to be provided to parent(s) or legal guardian(s) upon enrollment.  

For Program specific information contained in the Notice to Parents, DHS Publication No 14-01, Notice to Parents for Child Care Program.

Form 07LC046E