Child Information

Child's First Name

Child's Last Name

Enrolling Program

Sprouts: Tuesdays, Thursdays, 2.5-3 years olds

Buds: Mondays, Wednesdays and Fridays, 3-4 year olds

Pre-K Blossoms, Monday - Thursdays (Fridays) 4+ year olds

Age

Potty Trained?

yes

If not, we will include the $45 fee on your tuition invoice.

Potty Training Agreement Form

Yes, I agree

In order for Blossoming Buds Preschool to agree to take a child who is not potty-trained the following must be agreed upon: - There is a $45 extra fee per month for children that are not potty-trained. Please enclose a check with this form if you haven’t paid the fee for your first month. - The child must always arrive with a clean diaper on. - Blossoming Buds will be supplying all diapers and wipes. - You are aware that your child’s diaper will be changed several times a day. - If a student has a stool accident in their underwear, these underwear may be thrown away. This is to keep the school as sanitary as possible. Blossoming Buds’ Potty Trained Definition: Children at BBP who are potty trained come to school each day in underwear and can independently go to the bathroom on their own with only an occasional reminder. We understand accidents can happen once in a while but if accidents are happening on a daily/weekly basis the fee still applies. If you have any questions please do not hesitate to ask. Also, please ask if you need any tips to help potty-train your child. We will work on this together!

Child's Birthdate

Gender

Girl

Boy

Primary Phone Number

Home Address

Apt, suite, etc.

Country

City

State

Zip code

Email addresses for our class and all-school emails

Email #2

Email #3

Other members in household

Can your child's face be on our private Intragram feed?

Yes

Tell us more about your child: personality traits, likes/dislikes, habits, etc.

Best methods for consoling at school, i.e, time alone, hugs, talking it out, etc.

Would you like to be the room parent for your class?

Yes

Only if no one else volunteers

Parent/Guardian information

Parent/Guardian Name #1

Address Same as Student

Same

Address

Apt, suite, etc.

Country

City

State

Zip code

Phone

Employer

Parent/Guardian Name #2

Address Same as Student

Same

Address

Apt, suite, etc.

Country

City

State

Zip code

Phone

Employer

Other people allowed to pick-up

Name

Relation

Number

Name

Relation

Number

Name

Relation

Number

Pick-up passode

Please provide a passcode to give to new nannies, grandparents, etc when they are picking up for the first time. They will give us this passcode at pick-up.

Medical Information

Pediatrician's Name

Phone

Health Insurance Provider *

Policy #

Please list all allergies and health issues

If your child has food allergies:

They can have foods that are processed in the same facility as their allergy

No, they must stay away from all foods that are processed in the same facility

Please list all medications

Medical Waiver

I hereby give permission for my child to receive emergency treatment by a qualified staff member at Blossoming Buds Preschool. I also give permission for my child to be taken to the hospital by an aid car, ambulance, or staff car, if necessary.
In the event of an emergency and I cannot be contacted, I further consent to any medical, surgical, and/or hospital care, when deemed immediately necessary or advisable by a licensed physician/hospital in order to safeguard my child’s health.
I understand that I am 100% financially responsible for any emergency treatment that my child receives, including paramedics/ambulance services.
By signing below you agree to the above medical waiver.

Parent Signature *

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