APPLICATION FORM

Pre Enrollment Application Form
Exploradores Bilingual Daycare

1307 Calder Rd

Dale Texas 78616
Name of Child:
Age
Date of Birth:

MonthDayYear
Enrollment Schedule:
Full Time (Monday- Friday) or Part Time (Less than 4 days a week)
Receiving Child Care Assistance or Private Pay :
Parents' information
Mother's name:
Basic Information:
Father's name:
Basic Information:
List any family members assisting or that referred you
1.
2.
3.
Medical Consent in Case of Emergency:
In the event of a medical emergency, I would like Exploradores to contact
Doctor's Name:
Address:
If the above named doctor is not availlable Exploradores may take my Child to the nearest hospital. I give permission for said hospital and/or doctor to treat my Child.

Parents will be responsible for all medical costs
In the event of Medical emergency when I cannot be reached, I hereby authorize the administration of any medical procedure deemed necessary by the doctor, or should doctor be unavailable, by any other physician or medical personel.
Medical Facts and History
Communicable Diseases

Other
Allergies:
Medications:
List any ongoing chronic medications that might impact the child's wellbeing while at the preschool
Medical Conditions
Please list any existing medical conditions that may impact the child's health and well-being in the preschool
Limitations to physical activity
Please list any existing medical conditions that may restrict the child's physical activity in the preschool
Special equipment
Please list any orthodontic devices/prosthesis, glasses etc.
Special equipment
Please list any orthodontic devices/prosthesis, glasses etc.
Allergies
Please list any allergies or reactions to any food, animals, pediatric asthma etc. Its very important to mention nut allergies
Special Diets
Any special diet/supplement that are medically prescribed should be included
Behavioral/Mental Health Issues
Please mention any behavioral conditions or mental health diagnoses eg. Autism, ADHD etc.
AUTHORIZATION & RELEASE FOR EPIPENS AND INHALERS
Please tick the correct option
Directions for use
Please indicate dosage, frequency etc of Epipen
I, parent's name, parent/legal guardian of child's name request that the administration of the above noted medication be provided. I understand that the service will be provided by a person with no medical or nursing training. All training will be parent's responsibility. I agree to provide Exploradores Bilingual Daycare with an updated medical statement if there is any change in the physicians instructions with respect to medication. I hereby release Little Barn Academy, its employees and contractors from all manner of actions, causes of actions, lawsuits, damage or injuries, however caused, arising out of the administration or failure to administer medication as provided herein.SignatureDate
PHOTO CONSENT
I hereby give my permission to the staff of Exploradores Bilingual Daycare to photograph my child. I understand that these photographs may be posted in the academy or on the website or social media where they may be viewed by individuals other than preschool participants. I acknowledge further that parents of other preschool learners might take pictures of their own children that might include my child.
Date:

MonthDayYear
Signature
AS PARENT/GUARDIAN OF SAID APPLICANT, I DO HEREBY GRANT PERMISSION FOR MY CHILD TO PARTICIPATE IN ALL SCHOOL ACTIVITIES, WHICH FORM PART OF THE DAILY ROUTINE.
I hereby grant permission for my child to use all of the play equipment and participate in all of the activities of the school, and to leave the school premises under the supervision of a staff member for scheduled field trips.
Exploradores Bilingual Daycare endeavour to adhere to the highest standard of care while looking after your child. However, Exploradores Bilingual Daycare cannot be held liable for any injury or loss of any nature suffered, which occurred due to events beyond its reasonable control. Exploradores Bilingual Daycare cannot be held liable for the actions of third parties not associated with Exploradores Bilingual Dayace or natural disasters. This indemnity does not include the negligence of Exploradores Bilingual Dayacre, its agents or employees.
Signature of Parent/Guardian
Departure Consent
I, as legal guardian/Parent hereby authorize the following persons to pick up my Child from the Preschool
Relationship:
Name:
Address:
Cell Phone:
DL #:
Relationship:
Name:
Address:
Cell Phone:
DL #:
Please note: ID is required to collect kids from school
MEETINGS

PARENTS MAY DISCUSS CONCERNS WITH THE SCHOOL. AN APPOINTMENT IS REQUIRED TO ENABLE A DISCUSSION TO BE CONDUCTED UNDISTURBED.
RULES & REGULATIONS
- ON ACCEPTANCE, A FEE OF $250 IS REQUIRED FOR REGISTRATION WHICH IS NON-REFUNDABLE.
- THE SCHOOL FEES ARE PAID IN ADVANCE, FAILURE TO PAY SCHOOL FEES WILL RESULT IN SERVICE BEING TERMINATED FOR YOUR CHILD, NO PAYMENT MEANS NO SERVICE. ONE CALENDAR MONTH’S NOTICE IS REQUIRED SHOULD YOUR CHILD LEAVE THE CENTRE.
- WE DO NOT EXCEPT NOTICES HALF WAY THROUGH THE MONTH. A FULL MONTH’S FEE IS PAYABLE WHETHER YOUR CHILD ATTEND OR NOT.
- THE SCHOOL OPERATES MONDAY TO FRIDAY FROM 6:30 AM TO 5:30 PM AND FRIDAY FROM 7AM TO 5:00 PM. MONDAYS TO FRIDAYS, THE GATE WILL BE CLOSED FROM 9:00 AM TO 2:30 PM, WITH THE EXCEPTION OF FRIDAYS
- FRIDAYS IT WILL REOPEN AT 1:30PM, PLEASE ARRANGEMENT WITH ADMIN OR DIRECTOR IF THERE IS A NEED TO PICK UP YOUR CHILD BEFORE THAT.
- APPROVAL WILL BE NEEDED IF YOUR CHILD WILL BE DROPPED OFF AFTER LATE DROP OFF, 9AM. PHONE CALL OR BRIGHTWHEEL MESSAGE MUST BE SENT NO LATER THAN 8AM TO INFORM OF LATE ARRIVAL
- CHILDREN PICKED UP LATER THAN THE INSTRUCTED TIME, SHALL PAY A PENALTY OF $1.00 FOR EVERY MINUTE PAST CLOSING TIME.
- EACH CHILD SHOULD HAVE AN EXTRA SET OF CLOTHES, IN CASE OF AN ACCIDENT. THE CLOTHES WILL REMAIN AT SCHOOL.
- PARENTS ARE REQUESTED TO CHECK THEIR CHILDREN’S BAGS FOR WET CLOTHING AND NOTES FROM THE TEACHER. MESSAGE BOOKS MUST BE SIGNED AND READ EVERYDAY.
- ALL ITEMS MUST BE CLEARLY MARKED AS THE SCHOOL IS NOT RESPONSIBLE FOR LOST ITEMS.
- CHILDREN ARE NOT ALLOWED TO WEAR FANCY EARRINGS, GLOVES, RIBBONS AND JEWELLERY TO SCHOOL AS WE WILL NOT BE HELD RESPONSIBLE FOR LOST ITEMS.
- ONLY PRE-APPROVED PERSONS WILL BE ALLOWED TO PICK UP YOUR CHILD. IF ADVANCED NOTICE IS NOT GIVEN, THEY WILL NOT BE ALLOWED TO TAKE THE CHILD. PLEASE PHONE IN ADVANCE IF THERE IS A CHANGE OF TRANSPORT OR A NEW PERSON PICKING UP YOUR CHILD.
- YOUR CHILD CAN CELEBRATE THEIR BIRTHDAY WITH HIS/HER CLASS. WHEN ITS THEIR BIRTHDAY, PLEASE ARRANGE WITH THE DIRECTOR AND ADMIN IN ADVANCE. ONLY CUP CAKES AND JUICE ARE ALLOWED
- CHILDREN MUST WEAR COMFORTABLE CLOTHES TO SCHOOL. NO BELTS AND NO HIGH HEELS.
- THE SCHOOL PROVIDES MEALS MON-FRI. PARENTS CAN REQUEST COPY OF MENU
- NO SWEETS, CHIPS, CHOCOLATE ETC. IS ALLOWED IF PROVIDING LUNCH OR EXTRA FOOD
I hereby confirm that I have read and understood the rules and regulations of the school and will adhere to these rules at all times.
Print name
Signature
Date (MM/DD/YYYY)
2026 Tuition

Full Time (4 days +), Part Time (up to 3 days), Drop in
Agreement

Tuition agreement will be provided and must be signed before start
Infants (6 weeks- 17 mo)

Full Time: $1040

Part Time: $995

Toddlers (18 mo- 35mo)

Full Time: $995

Part Time: $900

Preschool (36 mo-4yrs)

Full Time: $895

Part Time: $800

School Age: (4yrs+)

Full Time: $790

Part Time: $750
Other Fees

Material Fee: $10 a month
Payment due dates are on the first day of each month, payable in advance. with notice. Payment plans can be arranged with approval of admin.
I, the parent hereby understands how the payment plan works and commit to adhere to our agreement of payment as stipulated above.

Parent/Gaurdian responsible for school fees:
Signature
Date

MonthDayYear
Should be Empty:

Parents' information

Medical Consent in Case of Emergency:

Medical Facts and History

AUTHORIZATION & RELEASE FOR EPIPENS AND INHALERS

PHOTO CONSENT

Departure Consent

MEETINGS

RULES & REGULATIONS

2026 Tuition

Agreement

Other Fees

Payment due dates are on the first day of each month, payable in advance. with notice. Payment plans can be arranged with approval of admin.