Enrollment Form

Enrollment Form

Montclair Early Learning Center Orientation For New Children
Name that you want us to call your child when at center*
Parents Name*

First NameLast Name
Welcome to Montclair Early Learning Center. We want to make the first days here a positive experience for both you and your child. Below is a list of orientation items that will help you become aquainted with MELC. An interpreter is available if needed.
Before your first day at MELC, you should have the opportunity to participate in the below options. If you have not, please contact admin.*

Tour of facilityMeet new teachers and other key employeesVisit with classroomExtended Visits are available for both parent and child to allow both to be comfortable in the new surroundings. If your child is older than 6 months, we recommend you utilize this on a day you will be able to stay with your child and take them with you after the visit, as routine drop offs are usually best for adjustments.Parent resources, including a binder listing community agencies and services available, are located in the front lobby on the entrance table. If you ever have concerns about your child, please let admin know and we can point you in the right direction.Our school calendar and monthly newsletters include family involvement activities. These are both posted in the front lobby and on our website.We understand that parents are the primary influence and caretaker of the child. You know your child better than anyone. If you have any problems or complaints about anything at school, even if they are little, please talk with your child’s teacher or admin, so we can make it better for you and your child.Discuss needs of child and expectations of the family. List below if applicable:
Technology Usage:

At MELC, there are two cameras in every classroom as well as cameras outside and in the front entrance. The footage records and saves for up to three weeks. Footage may be saved longer for educational and safety purposes.

We use the parent communication app ChildPilot at MELC. You will recieve an invite to set up an account. You can pay tuition bills, monitor your child's daily activities and communicate with your child's teacher. If you need to reach admin, please email as opposed to messaging in the app.
Health and Developmental Expectations

MELC is a center for well children. An updated immunization record and a physian's note of health is required for admission. Vision and developmental screenings are conducted yearly at MELC.
Diapering options*

I would like to enroll in MELC Diaper program ($45/month) Includes diapers/wipes/diapering supplies.I would like to send my own diapers and just use MELC wipes & diapering Supplies($20/month)
Parent Signature*

Clear
Date*

MonthDayYear
Date
Admin use*

Blue CardChild Pre-admission recordMedia ReleaseTuition PoliciesChild’s Information SheetDr. Note of HealthFeeding ScheduleAllergiesAdd to ProCareEmail listQuick BooksClass listPlayground logTake Info Sheet to classroomCribHookCubbyCar seatBoardFamily picBirthdayCreate file
Policies

Please sign in the boxes below stating that you understand the policies on this page
Deposit & Registration Fee
I understand my deposit of $400 and registration fee of $90 are unconditionally nonrefundable. The deposit may be used as my child’s last two weeks of school if I give a written thirty-day notice.
Signature*

Clear
Full-Time Students
I agree to pay full-time tuition every month when my child has started school. I understand that I must pay tuition despite the absence of my child
Signature*

Clear
Tuition
I agree to pay my child’s tuition by 5:30 pm on the 5th of each month when paying monthly. I understand that a $ 10 penalty will be charged each week if tuition is not received on time.
Signature*

Clear
Handbook Acknowledgment / Agreement
I have received and understand the policies in the Montclair Early Learning Center Parent Handbook, including the positive discipline and guidance policies. I have had an opportunity to ask questions about the policies and I am willing to abide by the policies.

A copy of the MELC Parent Handbook is available on the enrollment landing page. If you have trouble downloading it, please let us know.
Signature*

Clear
MEDIA RELEASE PERMISSION
Child's Name*

First NameLast Name
I hereby give Montclair Early Learning Center, Inc. the right and permission to publish/use photographs, video footage, digital imagery, and/or audio tapes of my child.

I understand that such reproductions could be used to publicize/promote the school district through the commercial print or television media and through its own media productions.

I waive any right to inspect and/or approve the finished product and do release Montclair Early Learning Center, Inc. from any liability by virtue of distortion by processing. I further agree that these items may be used for publication, broadcast, or reproduction without limitation, or reservation or any fee.

I give my consent to use such photographs, video and audio recordings to be published on our parent app and social media. Montclair ELC will not post names of any child on social media.
Parent's Signature*

Clear
Date*

MonthDayYear
Date
Child’s Information Sheet
Child's Full Name*

First NameLast Name
Nickname
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Date
Parent / Guardian Information
Parent / Guardian #1*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number*
Employer
Work Phone Number
Cellular*
Email*
Parent / Guardian #2*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number*
Employer
Work Phone Number
Cellular*
Email*
Child may be released to:
Name*
Phone Number*
Please enter a valid phone number.
Name
Phone Number
Please enter a valid phone number.
Name
Phone Number
Please enter a valid phone number.
Name
Phone Number
Please enter a valid phone number.
Name
Phone Number
Please enter a valid phone number.
Person(s) to contact in an emergency when the parent(s) cannot be reached:
Contact Person #1 Name*
Phone Number*
Please enter a valid phone number.
Relationship to child*
Contact Person #2 Name*
Phone Number*
Please enter a valid phone number.
Relationship to child*
Child's Doctor*
Phone Number*
Please enter a valid phone number.
Allergies*
If no known allergies, please write NONE.
Signature of Parent or Guardian*

Clear
Date*

MonthDayYear
Date
FOOD ALLERGY and/or SPECIAL DIETARY REQUIREMENTS

This page must be completed and signed by the child’s health care provider and parent or guardian.
Child's Full Name*

First NameLast Name
Does your child have any known food allergeis?*

Describe allergic reactions and symptoms associated with this child’s particular allergies.*
Describe the treatment plan for the early learning provider to follow in response to child’s allergic reaction (include names of medication, dosage amount, and directions for how to administer medication).*
Other special dietary requirements due to a health condition.
Parent or Guardian Signature*

Clear
Date*

MonthDayYear
Date
Montclair ELC will notify parents / guardians immediately if if your child ingests any food they are known to be allergic to or if we suspect your child is having an allergic reaction. When epinephrine must be administered, MELC will immediately contact the emergency medical services.
Should be Empty:

	Food the child must not consume (List each food separately)	Appropriate substitute Food(s)
1
2
3
4
5

Enrollment Form

Policies

MEDIA RELEASE PERMISSION

Child’s Information Sheet

Parent / Guardian Information

Child may be released to:

Person(s) to contact in an emergency when the parent(s) cannot be reached:

FOOD ALLERGY and/or SPECIAL DIETARY REQUIREMENTS