Preschool Application

Applying For (Program/Class)

Student Name

Date of Application

Date

Student Address

Student City

Student State

Student Zip

Age as of Sept. 1st

Student Date of Birth

Date

Student Sex

Place of Birth

If my child is over 12 months, have they started walking and talking?

Is your child potty trained?

Are there any diagnosis and / or medical conditions of which we should be aware?

Does my child have allergies? If so, what?

Is my child on any special medication? If so, what?

What are my child's favorite things?

Who does the student reside with?

Natural Father’s Name

First NameMiddle NameLast Name

Father's best phone number

Please enter a valid phone number.Format: (000) 000-0000.

Father Marital Status

Father Pick-Up Allowed

Father Address (if different than student address)

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Father City

Father State

Father Zip

Father Employer

Father Work Phone

Please enter a valid phone number.Format: (000) 000-0000.

Father Email

example@example.com

Natural Mother’s Name

First NameLast Name

Mother's best phone contact

Please enter a valid phone number.Format: (000) 000-0000.

Mother Marital Status

Mother Pick-Up Allowed

Mother Address (If different than student's address)

Mother City

Mother State

Mother Zip

Mother Employer

Mother Work Phone

Please enter a valid phone number.Format: (000) 000-0000.

Mother Cell Phone

Please enter a valid phone number.Format: (000) 000-0000.

Mother Email

example@example.com

Other Children Enrolled at ECA?

If yes, list names and grades

Who has legal custody of the child?

Required Documentation Checklist

What are you hoping your child will receive at Excel Preschool?

Parent 1 Signature – Enrollment Agreement

Initials for Statement 1 - The School is not responsible for the loss of personal property, whether the loss occurs by theft, fire, or any other cause.

Initials for Statement 2 - All students enrolled at Excel Christian Academy must have in their school file a birth certificate, school physical, valid immunization records, and current custody papers if applicable. It is the sole responsibility of the parent to provide the school with any immunization changes or updated legal documents.

Initials for Statement 3 - Excel Christian Academy admits students of any race, color, national and ethnic origin to all rights, privileges, programs, and activities generally accorded or made available to students at the school.

Initials for Statement 4 -My child is permitted to take part in all school activities, including but not limited to, outside and inside activities, school sponsored events, and absolve the school and church from liability to me or my child in case of accident or injury to my child while on campus or during any school sponsored outing.

Initials for Statement 5 - As parents, we sincerely pledge our loyalty to the aims and ideals of the school.

Initials for Statement 6 - As parents, we hereby invest authority in the faculty and administration concerning the discipline of our child as necessary. We further agree that we will support the faculty and administration in discipline at home as needed.

Initials for Statement 7 - As parents, we agree, in accordance with the principle of Matthew 18:15-17, to bring any and all questions and criticisms to the person most directly involved. If we have a question about a specific classroom action or procedure, we will contact the appropriate teacher. If a satisfactory conclusion is not reached, we will then contact the school office to schedule a meeting with the appropriate administrator.

Initials for Statement 8 - I agree to resolve any concerns or questions about the school or its staff through direct, respectful dialogue with administration. We understand that creating negative or derogatory narratives on social media is harmful to our community and is contrary to our partnership, which could affect our child's continued enrollment.

Initials for Statement 9 - I agree to comply with and support the spiritual, moral, dress and disciplinary standards and policies of the school and further agree that the school has full discretion in the discipline of my child while under school supervision.

Initials for Statement 10 -I have read the FINANCIAL INFORMATION AGREEMENT and comply with those policies. I understand that failure to make payments in the required timeframe will be cause for suspension or dismissal from the program.

Initials for Statement 11 - I understand that I must transport my child in a car seat that is age appropriate each day and the staff has the responsibility to verify each child is leaving/arriving in a car seat. Failure to use a car seat will be reported to Department of Children and Families.

Initials for Statement 12 -I understand that if my child becomes ill while at preschool, the school has the responsibility to notify the parent and the parent will be required to pick up the child within 1 hour's time. Children with a fever, vomiting or green congestion will need to be symptom free for 24 hours before returning to school.

Initials for Statement 13- I understand that any person picking up my child must be listed as an authorized pick up in the student information system (Brightwheel or Gradelink) and that all persons are subject to show government identification.

Initials for Statement 14 - I understand that if I or any agent acting in my behalf or on behalf of my child brings any legal action against the school or its agents and such legal action is found in favor of the school or its agents, I will be responsible to pay all legal fees and other expenses related to such action. All disputes shall be settled in binding arbitration.

Parent 1 Date – Enrollment Agreement

Date

Hour MinutesAM/PM Option

Parent 2 Signature – Enrollment Agreement

Parent 2 Date – Enrollment Agreement

Date

Hour MinutesAM/PM Option

Parent 1 Signature – Acknowledgement of Biblical Worldview: As a Christ-centered school, a biblical worldview is the foundation of everything we do. This worldview is integrated into daily instruction across all subjects. Furthermore, all students are required to participate in weekly chapel services as a vital component of their spiritual development and our community life. We celebrate this distinctive approach to educating the whole child.

Parent 1 Date – Biblical Worldveiw

Date

Hour MinutesAM/PM Option

Parent 2 Signature – Biblical Worldview

Parent 2 Date – Biblical Worldview

Date

Hour MinutesAM/PM Option

Acknowledgment of Financial Information & Policies

Parent 1 Signature – Financial Information Acknowledgment

Parent 1 Date – Financial Information Acknowledgment

Date

Hour MinutesAM/PM Option

Parent 2 Signature – Financial Information Acknowledgment

Parent 2 Date – Financial Information Acknowledgment

Date

Hour MinutesAM/PM Option

I confirm I have paid the application fee at this link - https://square.link/u/UG7NOnnQ

Preschool Application

Student Information

Parent Information

Mother Information

Household and Enrollment Details

Agreements and Signatures