WPNS Admission Form

WPNS Admission Form

Please fill out the form to apply for preschool admission.
Child's Full Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Parent/Guardian 1 Full Name

First NameLast Name
Contact 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Parent/Guardian 2 Full Name

First NameLast Name
Contact 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Enroll myself and my child in WPNS starting:

MonthDayYear
Date
I would like my child to attend:
My choices for parent work days are:
i.e. 1st Choice: Tuesday, 2nd Choice: Friday, 3rd Choice: Wednesday
Any allergies or medical conditions?
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Woodland Parent Nursery School Parent Contract

I agree to the following:
1. To provide the following registration materials prior to my child’s first day of attendance:
- Physician's report for my child
- Emergency and Medical Release Form
- Negative TB test results for each working adult
- Signed statement of good health for each working adult
- Proof of MMR and TDaP Immunization for each in-class working adult
- Immunization record for each child in accordance with SB277
- $50 Registration fee and $50 Materials fee
- First month's tuition
2. To maximize my time spent as working parent, observing, playing, and interacting with the children without throughout the morning. Example of working schedule: for a child attending 2 days a week, parent will work 2 days/month.

3. The Director has my permission to release my child to the person(s) listed on the emergency card.

4. To sign my child in and out of school each day, and to notify the school when my child will be absent.

5. To assist in maintaining and cleaning the school, including scheduled work parties outside of school hours.

6. To attend monthly WPNS events, including Family Ed Nights and community socials.

7. To participate in fundraising events (i.e. raffles, Flapjacks and Tire Tracks) in whatever capacity is needed and appropriate. This may include soliciting donations, staffing events, and/or assisting in marketing for the event.

8. To hold a school job position - see handbook for more information.

9. To pay all monthly dues by the 10th of each month.

10. To give at least 2 weeks' notice and bring all my participation and financial obligations up to date if it should become necessary to withdraw from WPNS prior to the end of the school year.

11. To have a wonderful time with my child at WPNS, to ask questions, show my love, and facilitate healthy development for my child and all WPNS children.
Signature

WPNS Emergency and Medical Release Form
I, First Name Last Name , have placed my child(ren), First Name Last Name with Woodland Parent Nursery School.
I hereby authorize WPNS to have my child(ren) examined in the event of illness or injury during school placement and to obtain whatever medical care is recommended by a licensed physician.
Child(ren)'s Name(s)
Birthdate(s)
Home Address:
Primary Phone Number:
Secondary Phone Number:
Adults authorized to pick up your child:
Physician to be called in emergency (Name and Number):
Any allergies or medical conditions:

Volunteer Statement of Good Health
Woodland Parent Nursery School is a play-based, child-led, all-outdoor preschool program. WPNS requires that all personnel, including parent volunteers, be in good health and shall be physically and mentally capable of performing assigned tasks in order to ensure the health and safety of children enrolled. State regulations require that the good physical health of each volunteer that works at WPNS shall be verified by a statement, signed by the volunteer, affirming that they are in good health. By signing below, I am affirming that I understand the reasons a Statement of Good Health is required and that I am in good health.
Signature

Physician's Report

Pre-Admission Health Evaluation
Physician's Report
Should be Empty:

WPNS Admission Form

Woodland Parent Nursery School Parent Contract

WPNS Emergency and Medical Release Form

Volunteer Statement of Good Health

Physician's Report