Standard Contracts
RegistrationEnrollment/Application Agreement • February 12th, 2019 • Illinois
ENROLLMENT APPLICATION & AGREEMENTEnrollment Application & Agreement • January 31st, 2022
STUDENT INFORMATION Full Name Date of Birth Home Telephone No. Home Address City State Zip Code Date of Admission Date of Withdrawal PARENT CONTACT INFORMATION Mother’s Full Name Driver’s License E-mail Mobile Father’s Full Name Driver’s License E-mail Mobile Name, address and phone number of person to call in case of an emergency if parents / guardian cannot be reached: Relationship I hereby authorize The Woodlands Tree House Preschool to allow my child to leave the childcare operation ONLY with the following persons. Please list name, driver’s license number & mobile for each authorized person. Children will only be released to a parent or a person designated by the parent/guardian below after verification of ID. Name1. 2. Driver’s license #1. 2. Mobile 1. 2.
ENROLLMENT APPLICATION & AGREEMENTEnrollment Application & Agreement • January 13th, 2022
STUDENT INFORMATION Full Name Date of Birth Home Telephone No. Home Address City State Zip Code Date of Admission Date of Withdrawal PARENT CONTACT INFORMATION Mother’s Full Name Driver’s License E-mail Mobile Father’s Full Name Driver’s License E-mail Mobile Name, address and phone number of person to call in case of an emergency if parents / guardian cannot be reached: Relationship I hereby authorize The Woodlands Tree House Preschool to allow my child to leave the childcare operation ONLY with the following persons. Please list name, driver’s license number & mobile for each authorized person. Children will only be released to a parent or a person designated by the parent/guardian below after verification of ID. Name1. 2. Driver’s license #1. 2. Mobile 1. 2.
ENROLLMENT APPLICATION & AGREEMENTEnrollment Application & Agreement • February 13th, 2022
STUDENT INFORMATION Full Name Date of Birth Home Telephone No. Home Address City State Zip Code Date of Admission Date of Withdrawal PARENT CONTACT INFORMATION Mother’s Full Name Driver’s License E-mail Mobile Father’s Full Name Driver’s License E-mail Mobile Name, address and phone number of person to call in case of an emergency if parents / guardian cannot be reached: Relationship I hereby authorize The Woodlands Tree House Preschool to allow my child to leave the childcare operation ONLY with the following persons. Please list name, driver’s license number & mobile for each authorized person. Children will only be released to a parent or a person designated by the parent/guardian below after verification of ID. Name1. 2. Driver’s license #1. 2. Mobile 1. 2.
Email: mecca.information@gmail.com Website: www.masjidullahchildcare.comEnrollment Application Agreement • March 26th, 2018
Today’s Date: Desired Start Date: Actual Start Date: Child’s Full Name: Last, First, Nickname Date of Birth: FEE AMOUNT$ PER-DAY-WEEK DAY PAYMENT TO BE MADE □ all day care Services to be provided as part of the day care fee (examples; transportation, care, meals, etc.) □ part-time care □ meals □ transportation □ school pictures □ field trips □ scholastic books CHILD’S ARRIVAL TIME CHILD’S DEPARTURE TIME PERSON(S) DESIGNATED BY PARENT TO WHOM CHILD MAY BE RELEASED LATE FEE$ PER MIN-HR Gender □ Male □ Female Extra services to be provided at an additional fee if applicable□ after care □ before care □ trips □ other: I, the parent/guardian; □ received complete written program information at the time of enrollment. ( 3270.121, 3280.121, 3290.121)□ agree to update the emergency contact/parental consent form information whenever changes occur or every 6 months at a minimum. (3270.124, 3280.124, 3290.124) SIGNATURE-OPERATOR DATE SIGNATURE-PARENT OR GUARDIAN DATE DATE OF CHILD’S ADMISSI
