Full Student Application

Person(s) to be contacted in an emergency if parent(s)/guardian(s) cannot be reached:
Emergency Contact #1
#1 Name*
#1 Relationship to child*
#1 Address*
#1 Phone Number*
Please enter a valid phone number.
Emergency Contact #2
#2 Name
#2 Relationship to child
#2 Address
#2 Phone Number
Please enter a valid phone number.
Emergency Contact #3
#3 Name
#3 Relationship to child
#3 Address
#3 Phone Number
Please enter a valid phone number.

Student Health, Behavioral and Diet Profile

This section helps us better understand your child's health, behavior, and dietary needs. By sharing these details, you are providing our administration and caregivers the tools to provide consistent care, support, and a nurturing environment that feels just right for your child.
Is your child an infant solely on formula or breastmilk? (not yet eating baby or table foods)*

YesNo
Is your child on breastmilk?*

YesNo
Breastmilk Storage*

I acknowledge that bottles of breastmilk will be stored in the refrigerator upon arrival at Ardent Preschool.
Breastmilk Preparation*

Serve bottles of breastmilk coldWarm bottles of breastmilk in the crockpot
Breast milk must be prepared and stored in a bottle ready for use with the amount of milk for one feeding, labeled with the child's full name, and date of collection. *Frozen storage bags are not permitted.
Bottle's Breastmilk Amount in Ounces*
(example 3 oz.)
Additional Bottle/Breastmilk Feeding Instructions:
None
Breastmilk Policy*

Name of child's doctor*
Doctor's phone number*
Please enter a valid phone number.
Doctor's address*
Upload a copy of your child's Alabama Certificate of Immunization (shot record)

The unexpired original copy must also be presented prior to enrollment. Students are not allowed to attend without a valid/current Alabama Certificate of Immunization or Alabama Certificate of Religious Exemption.
Cancelof
Parent/Guardian Name:*

First NameLast Name
Parent/Guardian Signature*

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All electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.

Parental Agreement/Signature Page
I give permission for my child to participate in:
Activities away from the facility:*

YesNo
Transportation provided by the facility:*

YesNo
Swimming/wading activities provided by the facility:*

YesNo
Parent/Guardian Name*

First NameLast Name
Signature of parent/guardian*

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All electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.
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Student Enrollment Application