• The Willow School

    Parent Information and Contact Form
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  • PARENT/GUARDIAN INFORMATION

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • PARENT/GUARDIAN INFORMATION

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • EMERGENCY CONTACT INFORMATION: Other than Parent/Guardian


  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • I hereby grant permission for my child to attend and participate in The Willow School program(s) listed herein & agree to the Terms and Conditions set forth herein.  I hereby release and discharge The Willow School, teachers, and employees against all claims and losses of any type arising out of or relating to my child's participation in educational and care programs at The Willow School location.

    I am 18 years of age or older and the parent or legal guardian of the above-named child. 

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  • Medical Contact

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Sunscreen Consent

  •  Please apply sunscreen to your child every morning before drop off. As needed throughout the day, your child’s care provider will assist with applying sunscreen to bare surfaces, including the face, tops of ears, and bare shoulders, arms, legs, and feet, 15-30 min before outdoor activity. Sunscreen will not be applied to broken skin or if skin reaction has been observed. Any skin reaction observed by staff will be
    reported promptly to the parent/guardian.

  • Please check all that apply:
  • I am 18 or older and the parent or legal guardian of the above-named child. 

  • Date
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  • Bug Spray Consent

  • Please check all that apply:
  • Ticks

    The Willow School believes time in nature is essential to a child's development. We perform regular Bug Checks, looking out for ticks when there is no snow cover on the playground or the trail. 

    Ticks are an unfortunate nuisance; we must acknowledge and be prepared to deal with them when living in Maine. 

    If a tick is found crawling on your child, it will be removed immediately and preserved in a baggy for potential future testing, and the child's parent will be notified as soon as possible. 

  • If a tick is embedded
  • I am 18 or older and the parent or legal guardian of the above-named child. 

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  • Consent to Share Students Image

  • Your child's digital safety is important to us, so we would like your consent to take their photograph while at school. Teachers cannot share pictures of students with those not employed or enrolled at The Willow School. 

    The Willow School teachers and staff take digital photos of students throughout the year to document their development and experiences. 

    We also use images of the student's faces to assist them in navigating transitions throughout the day - for example, the label for the cubby and their circle and lunch spot cards. 

     

  • Please check all that apply:
  • I am 18 or older and the parent or legal guardian of the above-named child. 

  • Date
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  • Play Ground Agreement

  • I allow my child to participate in mixed-age playtime on the playground. At times, both toddler and preschool groups will enjoy the playground together. During these joint play sessions, teachers will be strategically placed around the playground to ensure supervision, safety, and engagement for all children. This practice supports social learning and community while maintaining safe ratios and oversight.

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  • Class Contact Information

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  • Once you have completed all the forms, please have your child's primary care physician send us a copy of your child's Immunization Records to our fax number 207 221 5725 at your earliest convenience.

    The Department of Health and Human Services does not allow us to enroll or accept students into our care without receiving their latest Immunization Records. 

    Thank you so much for taking the time to fill out these forms. I know that it is time-consuming, though the information is essential for us to provide the best care possible to your child. 

    Please reach out to us with any questions or concerns.

    We look forward to welcoming you all soon! 

    Warmest Regards,

    Jenny 

     

  • Authorized Pick-Up

  • Please provide the names and phone numbers of anyone you authorize to transport or pick up your child. We will only release your child with prior written notification, and regardless of familiarity, we will always confirm identity by requesting to see a valid form of identification.

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