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HEA Preschool Registration 2015 - 2016

 
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Registration Information

as of 10/01/14

Persons to be contacted in case of emergency (Only if parent cannot be reached)

Statements of Authorization and Release Form

I hereby give my permission to the HEA to call a doctor for medical or surgical care for my child, should an emergency arise. It is understood that a conscientious effort will be made to locate my spouse or me before any action will be taken. If it is not possible to locate us, this expense will be accepted by us. The Director or Staff is authorized to execute all documents and releases necessary to obtain such medical or surgical care. This authorization is valid until August 31, 2015.

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No

I authorize HEA preschool staff to apply sunscreen that will be supplied and labeled by me, to my child.

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No

I understand that according to the Colorado Division of Child Care (7.702.41) all staff members are required to report any suspicion of child abuse and/or neglect to the appropriate authorities.

Yes
No

Media Release:

I authorize the HEA Preschool and its affiliates to contact me using the contact information provided by me on the application. The HEA will not release this contact information to non affiliates.

Yes
No

I authorize the use of my child’s photograph and name in annual HEA Synagogue and Preschool publications and in class e-mailings.

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No

I authorize the Hebrew Educational Alliance Preschool to release my child’s photograph only for publication on the HEA website, and to be used by affiliated community publications and national funders such as Rose Community Foundation and Jewish Federation.

Yes
No

I also give permission for my child to go on walking field trips away from the premises of the school. I understand I will be notified in advance of such trips and they will be within appropriate walking distance.

Yes
No

Authorization to Release

Developmental Questionaire

It will be most helpful to the H.E.A. Preschool teachers to know as much about your child’s home background and social and emotional growth as possible. We would appreciate you taking a few minutes to fill in the following questions.

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No

On-site services available

Yes
No
Yes
No

Speech Characteristics

Behavioral Traits

Temper Tantrums
Timidity
Aggressiveness
Nervous habits
Reaction to Authority

Social Traits

How do you feel your child gets along with others?

Personal Care Habits

Family Information

Living Together
Separated
Divorced
Yes
No

General Health

Frequent Colds
Ear Infections
Stomach Aches
Fevers
Runny Nose
Eye Infections
Seasonal/Environmental Allergies

School Experience

Supply List

1. 2 boxes of tissue
2. 3 pump bottles of Soft Soap hand soap (not antibacterial)
3. 4 boxes of baby wipes
4. 1 plastic shoe box size container with complete change of clothing inside including 2 pairs of underwear if used by child – please write your child’s name on the box and each piece of clothing
5. 1 package of diapers or pull-ups if used by child
6. 1 lunch box
7. 1 backpack (optional)- no drawstring backpacks allowed
8. 1 crib size sheet labeled with child’s name on it (please use sharpie), if staying for the afternoon enrichment program or $10 and we will purchase a sheet for your child to use. Sheets will not be returned and we will launder them regularly.
9. One box of bandages

Payment
$
Directory Release

Each year the preschool publishes a school directory. Please provide the information, sign and return this form to be included in the directory.

Required Information

Optional Inclusion

I do not wish to be included in the Preschool Directory. The directory is for the sole use of HEA Preschool and currently enrolled families; I understand that the unauthorized use of the directory is strictly prohibited.
I authorize the above information to be published in the Preschool Directory. The directory is for the sole use of HEA Preschool and currently enrolled families; I understand that unauthorized use of the directory is strictly prohibited.
Volunteer Form

Are you interested in getting involved at the preschool? We have a number of opportunities for involvement throughout the school year. Please sign up for committees and/or events that interest you. A Parent Committee member will contact you after the start of school with more details.
Thank you!

I would be interested in being a room parent.
I would be interested in Chairing the Care Committee - The Care Committee helps wielcome new parents to the preschool, organizes meals to families who have experienced a lifecycle event, organizes community service projects, etc.
I would be interested in being on the Care Committee
I would be interested in colunteering within my child/children's classroom(s)
I would be interested in volunteering for school wide events.

Account Details

Enter your name and e-mail address for your confirmation:

Payment Information

Increase the amount by 3% to cover credit card fees. Please select YES to increase your payment.
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