Museum School Fall/Spring 2023-2024 Enrollment Form

Fall/Spring 2023-2024 Enrollment Form

Children must turn 3-6 years of age by September 1, 2023
To secure your child's place for the Fall/Spring 2023-2024 school year, please complete and submit this Enrollment Request Form. You will receive an Admission Letter (or wait list notice) at the primary email address listed on the enrollment form.

Spaces are available on a first-come-first-serve basis. Classes filled quickly; availability is limited. YOU MAY BE REGISTERING FOR A CLASS THAT IS NO LONGER AVAILABLE.
Child's Name*

Child's First NameChild's Last Name
Child's Preferred Name (if applicable)
Child's Birthdate*

MonthDayYear
Child's Age by September 1, 2023*
Child's Gender*
Please select one:*
What is the name of the child enrolled in the 2022-2023 school year?*
Child's Name
Has your family attended Museum School in the past?*
Please select a date range that your family was in attendance.*

Fall 2020 - Summer 2022Prior to Fall 2020
IMPORTANT

Only current Fall/Spring 2022-2023 students, their siblings, and FWMSH members are eligible to register for Fall/Spring 2023-2024 classes at this time.

Registration will open on the Museum School WEBSITE on February 20, 2023 at 10:00am.
If you selected grandparent, please note that the parent/guardian must complete and sign this enrollment form.
Name Used on the Membership

First NameLast Name
Membership Number
Membership Expiration Date

MonthDayYear
Date
Child's Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child Care Regulation requires two parents/guardians be listed for your child so that Museum School has the necessary emergency contact information.
Parent/Guardian #1 *

First NameLast Name
Relationship to Child*
Parent/Guardian #1 Phone Number*
Please enter a valid phone number.
Parent/Guardian #2 *

First NameLast Name
Relationship to Child*
Parent/Guardian #2 Phone Number*
Please enter a valid phone number.
TWO DIFFERENT email addresses are REQUIRED. Please list a separate email address for each parent/guardian listed above.

All email correspondence will be sent to the PRIMARY email address.

All Procare notifications and alerts will be sent to both email addresses.
Primary Email Address*
example@example.com
The PRIMARY email address belongs to:*

Parent/Guardian #1Parent/Guardian #2
Secondary Email Address*
example@example.com
The SECONDARY email address belongs to:*

Parent/Guardian #1Parent/Guardian #2
What language is primarily spoken at home?*
Is your child of Hispanic, Spanish or Latino Origin?*
Child's race:*
Does your child have any allergies?*
If yes, please explain.*
Does your child require an Epi Pen and/or Benadryl?*
I verify the following:*

I understand that a FARE Allergy Action Plan is required to be signed and dated AFTER JUNE 1, 2023 by myself and my child's medical professional. I will download the FARE form from the Museum School website and provide it to the school between June 1, 2023 and August 11, 2023.I will provide my child's Epi Pen and/or Benadryl on his/her first day of class.
Please list any information teachers should be aware of, such as specialized therapy, food intolerances, existing illness, previous injuries and hospitalizations during the past 12 months; medications prescribed for long-term continuous use, and any educational needs:*
Child's Physician's Full Name*

First NameLast Name
Physician's Street Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Physician's Phone Number*
Please enter a valid phone number.

CHILD RELEASE & INFORMATION
Will you be carpooling with another family? If you do not know at the time of enrollment, you may email museumschool@fwmsh.org at a later date with additional information.*

NoYesNot Sure
Please list the names of the children (other than siblings) in your carpool.
Each individual designated below will be assigned a unique pin number in Procare. Child Care Regulation requires two emergency contacts OTHER THAN THE CHILD'S PARENTS/GUARDIANS.

Emergency contacts and individuals authorized for pick up do not have the ability to download the Procare app and access student information. They will provide their unique pin number to a Museum School Staff member at drop off and pick up.

Emergency Contacts are automatically considered authorized to pick up/drop off children, so there is no need to enter the Emergency Contacts twice. Please do not enter the child's parents/guardians as it will delay processing your child's form.
Emergency Contact #1 *

First NameLast Name
Emergency Contact #1*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact #1*
Please enter a valid phone number.
Relationship to Child*
Emergency Contact #2 *

First NameLast Name
Emergency Contact #2 *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact #2*
Please enter a valid phone number.
Relationship to Child*
Authorized Pick Up #1

First NameLast Name
Authorized Pick Up #1*
Please enter a valid phone number.
Relationship to Child*
Authorized Pick Up #2

First NameLast Name
Authorized Pick Up #2*
Please enter a valid phone number.
Relationship to Child*
Authorized Pick Up #3

First NameLast Name
Authorized Pick Up #3*
Please enter a valid phone number.
Relationship to Child*
Authorized Pick Up #4

First NameLast Name
Authorized Pick Up #4*
Please enter a valid phone number.
Relationship to Child*
Authorized Pick Up #5

First NameLast Name
Authorized Pick Up #5*
Please enter a valid phone number.
Relationship to Child*
I authorize Museum School to release my child ONLY with the persons listed above. There will be NO EXCEPTIONS. Children will only be released to a parent/guardian, emergency contact or authorized person for pick up after verification of Procare Pin Number (provided by Museum School) and/or photo ID. If I need to add additional persons or remove anyone on this list, I will email Museum School at museumschool@fwmsh.org with the request in writing.*
The following information is confidential and will be used by your child's teachers to ensure the best Museum School experience for your child. Please enter "N/A" if it is not applicable to your child.
Names and ages of brothers and/or sisters.*
Please list your child's current schools and/or activities.*
Favorite interests, pets, etc.*
Recent changes in home life (moving, births, deaths, etc.)*
Parent/Guardian Signature*

Clear
Parent/Guardian Name*

First NameLast Name
Date*

MonthDayYear
Date
Should be Empty:

Fall/Spring 2023-2024 Enrollment Form

IMPORTANT

CLASS REQUEST & PARENT AUTHORIZATION FORM

Please select your 1st, 2nd and 3rd class preferences below. THIS FORM DOES NOT REFLECT CLASS AVAILABILITY. CLASSES FILLED QUICKLY. AVAILABILTY IS LIMITED. YOU MAY BE SELECTING CLASSES THAT ARE NO LONGER AVAILABLE.

SCHOLARSHIPS: If you are interested in applying for a Fall/Spring 2023-2024 scholarship for your child, please click HERE. The Scholarship Application must be submitted with the Enrollment Form.

CHILD RELEASE & INFORMATION