Knightdale Baptist Preschool Enrollment Packet

Thank you for your interest in Knightdale Baptist Preschool! Enclosed in this packet are the forms you will need to fill out in order to enroll your child in preschool. If you have any questions, please call Knightdale Baptist Preschool at 266-2288 to speak to Christi Boggs - Preschool Director.

The following forms are enclosed in this enrollment packet:

• STUDENT APPLICATION- Please fill out in FULL. The emergency contact information and

persons authorized to pick up you child MUST be filled out before your child can be placed in a class.

• MEDICAL FORM -The preschool must have a completed Medical Form at registration for

your child to be enrolled. Please contact your child's pediatrician if you have any questions about the information requested.

• IMMUNIZATIONS- An updated copy of your child's shot records must be completed and

turned in to the Director by the first day of school. A signed copy of the immunization letter provided in this packet must accompany it. Your child will not be allowed to attend school without their immunization records on file with the Director.

• PARENT AGREEMENT- This agreement MUST be signed and dated by the child's

parents by the first day of school. Before you sign, be sure you read and understand the information in the Parent Handbook. Parent Handbooks are available upon request prior to orientation night.

You are welcome to tour the preschool facilities prior to enrollment. For a guided tour, please call the preschool office to schedule an appointment with the Preschool Director.

Enrollment Procedures:

• Completely fill out the required forms included in the Enrollment Packet. • Turn in all forms, along with a check for the registration fee, to the Preschool Director. If

there is space in the class you requested for your child, your child will be placed in that class.

• Children are placed in a class based on their age as of October 16th of the upcoming school year.

• A copy of your child's updated immunization forms and signed note from their doctor is due to the Director prior by the first day of school.

• You will receive information about your child's teacher and the preschool orientation in the middle of August.

Knightdale Baptist Preschool 15 Main Street

Post Office Box 21 Knightdale, NC 27545

919.266.2288 STUDENT APPLICATION

CHILD'S NAME: ----------- - DATE OF BIRTH: _

ADDRESS: _

PHONE NUMBER: CLASS REQUEST: _

FATHER'S NAME: WORK PHONE: _ _

FATHER'S EMPLOYER: JOB TITLE: _

MOTHER'S NAME: WORK PHONE: _

MOTHER'S EMPLOYER: JOB TITLE: __

ARE BOTH PARENT'S IN THE HOME? _

If no, please explain:--- - - - ----------- --- -----

---- - RELIGIOUS AFFILIATION: _ _ _

HOW DID YOU HEAR ABOUT THE PRESCHOOL?- ----- ------- - - ---

EMERGENCY CONTACT NAME (other than parents): --- ---- - - --- - - ---

PHONE NUMBER: RELATIONSHIP: _

PREVIOUS CHILDCARE, PRESCHOOL, PLAYGROUP EXPERIENCE:

OTHER CHILDREN IN THE FAMILY (names & ages):

PERSONS AUTHORIZED TO PICK UP YOUR CHILD: NAME: PHONE NUMBER: _

SIGNATURE: RELATIONSHIP: _

NAME: PHONE NUMBER: _

SIGNATURE: RELATIONSHIP: ------------

Knightdale Baptist Preschool

MEDICAL FORM

CHILD'S NAME: DATE OF BIRTH: __ _

DOES YOUR CHILD HAVE ANY KNOWN ALLERGIES? (FOOD, MEDICINE, ENVIROMENT, ETC.):

DOES YOUR CHILD HAVE ANY PHYSICAL DISABILITIES OR LIMITATIONS?

IS YOUR CHILD ON ANY CONTINOUS MEDICATIONS?

CHILD'S DOCTOR: PHONE NUMBER: _

DOCTOR'S ADDRESS:------------- - - --

--

CHILD'S DENTIST: PHONE NUMBER: ___

HOSPITAL PREFERENCE:- - - - - -- - - -

- - - - - - --

INSURANCE COMPANY: POLICY NUMBER: _

This form must be completed prior to registration. A copy of your child's immunization record must be submitted along with this form. State law requires this. Your child will not be allowed to start preschool if the immunization record is not on file with the Director.

I agree that the Director may authorize a physician other than the named doctor to provide

emergency care to my child in the event that neither parent nor the child's doctor can be contacted immediately.

PARENT SIGNATURE:- - - - - -- - - -

- - - - -- - - - DATE:--

------ - - - - - - --

Knightdale Baptist Preschool

IMMUNIZATIONS Parents please mail or fax this form to your child's pediatrician. Fill in your child's name and date of birth before forwarding to your child's doctor. They will need to sign and date it and mail or fax it to Knightdale Baptist Preschool as soon as possible. This information is due back to Knightdale Baptist Preschool no later than 2 weeks after the enrollment packet is turned in. A CURRENT COPY OF YOUR CHILD'S IMMUNIZATION RECORDS MUST ACCOMPANY THIS FORM.

To: Christi Boggs- Preschool Director

Child's Name: _ __

Date of Birth: __

RE: Immunization Records

I certify that the above named child is currently up to date on his/ her immunizations according to State Law and can attend preschool.

Doctor's Name:-------- - - -- - ---

Doctor's Signature: _ __ _______

Date of Signature: __ _ _

PLEASE ATTACH A COPY OF THE CHILD'S IMMUNIZATION RECORDS

PLEASE RETURN THIS FORM AS SOON AS POSSIBLE TO:

FAX: 919.266.0984 ATTENTION: Christi Boggs - Preschool Director

MAIL: Knightdale Baptist Preschool

15 Main Street Knightdale, NC 27545 ATTENTION: Christi Boggs - Preschool Director

Knightdale Baptist Preschool

PARENT AGREEMENT

This is an agreement between the parent and Knightdale Baptist Preschool. By signing this form, the parent agrees to the following:

• Tuition will be paid on the first day of class each month (Sept.- May). If tuition has not

been paid by the 10th of the month, a $10.00 late fee will be added. An additional $10.00 late fee wil be charged if tuition has not been paid in full by the 20th of the month. If tuition has not been paid in full by the last day of the month, the child will be released from the preschool program. At that time, tuition plus all late fees will be due in full. If a financial crisis arises and you are not able to make a tuition payment, you must contact the Director to make alternative arrangements.

• All children will be dropped off and picked up through the carpool system on time each

school day.

• Parent's will NOT send a sick child to school. Please refer to the Parent Handbook for the

Preschool's Sick Child Policy.

I have read and am in agreement with the above and with the guidelines stated in the Knightdale Baptist Preschool Parent Handbook.

Parent Name: Date: ----------------

Parent Signature: ------------------------------ ----

- Parent Name: Date: __

Parent Signature: ------------------------------ ------

- - Director Name: Christi Boggs Date: _

Director Signature: -----------------------------------------

*Please note: Parent Handbooks are available in the Director's office; you may pick one up at this location.