Enrollment Application

Please complete this application in its entirety, providing complete addresses and phone numbers for all parents, guardians, emergency contacts and authorized relatives. 

Child’s Living Arrangements:

Child’s Legal Guardian(s) :

The child may be released to the person(s) signing this agreement or the to following:

Persons to contact in the case of an emergency when parents cannot be reached:

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EMERGENCY MEDICAL AUTHORIZATION
PARENTAL AGREEMENT