AFTER-SCHOOL PROGRAM ENROLLMENT FORM

AFTER-SCHOOL PROGRAM ENROLLMENT FORM

2025-2026
AFTER-SCHOOL PROGRAM

REGISTRATION

Child’s Personal Details
My child's identity*

First nameLast name
Gender*

GirlBoy
Date of birth*

DayMonthYear
Date
Place of birth*
Citizenship*
Mother tongue*
Other spoken languages
Name of the School the Child Attends*
Home address *

Street

Street Address Line 2

City

Zip code

Personal information of the parents
Identity of*

FatherMother
FirstName
Citizenship*
Occupation*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address only if different from the child

Street

Street Address Line 2

City

Zip code
Identity of

FatherMother
First nameLast name
Citizenship
Occupation
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address only if different from the child

Street

Street Address Line 2

City

Zip code
Family status*

SingleMarriedDomestic PartnershipSeparatedDivorced
Child’s Siblings – (BROTHERS, SISTERS, FIRST NAMES AND DATES OF BIRTH)
How did you hear about Ma Petite École Montessori?*

Medical Information
Allergies or Medical Conditions to Declare:
Ongoing Treatment(s):

Daily Routines
Informations sur mon enfant :

My child takes a nap(Please note: nap time or quiet time is mandatory for children in the "Hedgehogs" class.)My child has a transitional object(Please note: scarves and necklaces cannot be considered as such due to safety risks, especially during nap time.)A Health Care Plan (PAI) needs to be implemented for my childMy child is followed by professionals outside of school(speech therapist, psychomotor therapist, psychologist, occupational therapist, neuropsychologist, etc.)
Feel free to share any information you believe would help us better understand and support your child (medical details, family context, life history, specific needs, etc.).

School Rules
Read and approved
Place * Date Date*
Signature*

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Autorisation de sortie

2025-2026
This authorization is valid for the 2025–2026 school year for all educational outings, cultural visits, park trips, and events organized as part of the educational program of Ma Petite École Montessori.
Child's identity*

First NameLast Name
Child's date of birth*

DayMonthYear
Date
I, the undersigned Prénom* Nom de famille* titulaire de l’autorité parentale sur Prénom* Nom de famille* authorize my child to participate in all school outings and educational activities organized outside of the school during the 2025–2026 school year, under the supervision of the teaching staff.
I also authorize the teachers to take any necessary measures in the event of a situation concerning my child's well-being.
Signature*

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List of authorized persons allowed to pick up your child

2025-2026
I, the undersigned Prénom Nom de famille Holder of parental authority over Prénom Nom de famille authorize the persons listed below to pick up my child from school
Authorized person n° 1

First NameLast Name
Authorized person n° 2

First NameLast Name
Authorized person n° 3

First NameLast Name
Authorized person n° 4

First NameLast Name
Authorized person n° 5

First NameLast Name
By signing this authorization, I release the school from any liability in the event of an accident occurring after my child has left school premises. Without authorization, students will be entrusted exclusively to the after-school care services.
Please note: Each authorized person must present their own ID.
Signature

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Lunchbox Option
Dear Parents,

For dietary or allergy-related reasons, you have chosen to opt for the lunchbox option.

The school will store your child’s lunchbox from drop-off until lunchtime, in compliance with hygiene standards and the traceability requirements set by regulations. The lunchbox will be reheated if necessary and served at the table using the school’s dishware. Your child will receive the same supervision and care during mealtime as all other students.
I, the undersigned Prénom Nom de famille parent of Prénom Nom de famillechoose not to use the school’s lunch service and opt to provide a daily lunchbox, prepared in accordance with the following standards.
I agree to comply with the following rules :

The meal must be brought to school in an insulated bag labeled with the child’s first name.Cold meals and meals to be reheated must be stored in two separate containers, each clearly labeled with a name tag.The container for reheating must be microwave-safe. All containers must also be dishwasher-safe.The meal must be pre-cut if necessary.The lunchbox and its containers must be impeccably clean.No food item past its expiration date will be accepted within the school.
Read and approved
Signature

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Fees and Options

2025-2026
Reminder of Fees:
- Registration fee: €100 (to be paid upon registration)
- Full-day rate: €85 (includes lunch – excludes school trips and optional workshops)
- Half-day rate: €45
- Unlimited monthly plan: €255 (includes lunch – excludes school trips and optional workshops)
⚠️ Important:

Children enrolled in the unlimited monthly plan must commit to a minimum of one term.
No deductions will be made in case of absence.

Payment is due upon receipt of the invoice.

In case of withdrawal from the after-school plan, a three-month notice must be sent by email to
oriane@mapetiteecolemontessori.com. These three months will be fully due, regardless of the reason.

⚠️ Late pick-ups may incur an additional fee of €20.
Registration of my child for Wednesday childcare:*

Occasional – €85 per dayUnlimited Monthly Plan – €255 per monthOccasional Half-Day (Morning: 8:30 AM to 11:30 AM) – €45Occasional Half-Day (Afternoon: 1:30 PM to 6:30 PM) – €45
Payment Method:*

Bank TransferDirect Debit
I, the undersigned Prénom* Nom de famille* , parent of Prénom* Nom de famille* wish to enroll my child in Wednesday care according to the selected options.
Signature*

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Bank Account Details – Ma Petite École Montessori
SEPA Direct Debit Mandate

By signing this form, you authorize Ma Petite École Montessori to send instructions to your bank to debit your account, and your bank to debit your account in accordance with the instructions from Ma Petite École Montessori.
You are entitled to a refund from your bank under the terms and conditions of the agreement you have with it.
A refund request must be submitted within eight weeks of the debit date for an authorized debit.
First name and name
Adresse

Street

Complément d'adresse

CityÉtat/Région

Zip code
Your Bank Account Details
IBAN
BIC
Creditor
- Name: Ma Petite École Montessori
- Address: 7 rue de Villafranca, 75015 Paris, France
- Type of payment: Recurring
Read and approved
Signed in : place Date Date
Signature

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Documents to be provided

2025-2026
Dear Parents,

You're almost there!
There’s just one last step: please provide the following documents to complete your child’s enrollment file.
Parent’s ID card or passport

Cancelof
A birth certificate or a photo of the family record book

Cancelof
A copy of the health record (up-to-date vaccination page)

Cancelof
A school insurance certificate

Cancelof
Bank Account Information (in case of direct debit)

Cancelof
Other

Cancelof

I, the undersigned Prénom* Nom de famille* holder of parental authority over the child Prénom* Nom de famille* hereby declare on my honor that all the information provided in this form is accurate, complete, and truthful.
Signature*

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AFTER-SCHOOL PROGRAM ENROLLMENT FORM

AFTER-SCHOOL PROGRAM

REGISTRATION

Personal information of the parents

Medical Information

Daily Routines

PERMISSIONS

School Rules

Autorisation de sortie

List of authorized persons allowed to pick up your child

Lunchbox Option

Fees and Options

Documents to be provided