Crystal Springs Co-Op Preschool 2017-2018 Registration

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-- Page 1 -- Child's Information

Child's Information

Child's Residence & Parent/Guardian's Information

Child's Medical Information

Child's Doctor

Child's Dentist

Medical Policy

Emergency Contacts

*The following contact information must be filled out in order to enroll at CSPS and the contact must be within easy distance of the preschool.

In case of emergency, if unable to reach parents, call:

In the event of a major disaster, such as an earthquake, the following nearby neighbor or friend will welcome your child if you or the above emergency contact (or other authorized adults) cannot make it to the school:

-- Page 2 -- "Working Parent" Information

The "Working Parent" information collected in this section of registration is defined as the primary adult that will be staying for one assigned day a week during the preschool class time to work in the "classrooms."  This adult may be the child's mother, father, grandparent, nanny or other designated adult that will follow the policies and guidelines as outlined in the handbookMembership Responsibility Agreement --pg40-- (will be updated by start of school) and risk manual.

Please Note: the "Working Parent" and contact information will be listed on the class roster.

"Working Parent" Contact Infomation

-- Page 3 -- Permissions


Internal use of photograph:  I give permission for my child to be photographed/videotaped in scheduled preschool activities. His/her photograph may be used internally -- in the classroom, end of year slideshow and preschool newsletter.

External use of photograph:  I give permission for my child to be photographed/videotaped in scheduled preschool activities.  His/her photograph may by used externally by CSPS and Shoreline Community College promotion including web sites - children will not be named.

NO photographs may be used:  I decline the use of any photographs of my child.  I understand that this means he/she will NOT be included in the end of year slideshow.
Participate in Scheduled Field Trips (Excursions)

Driving To/From Preschool & Field Trips (Excursions)

Emergency Medical Care

-- Page 4 -- Acknowledgements

Please read all statements below before marking

    1. Submit an online Parent Education Application (for Shoreline Community College -- separate from this form) 
    2. Completed, signed and dated Washington State Certificate of Immunization (must be on this form - doctor's office printout is not accepted. Please be sure to sign it!)
    3. $90 non-refundable registration fee (and $60 for each additional child enrolled) by check or money order onlymust have child's last name and class noted.
    4. September's tuition* can be paid by anytime between now and May 19, 2017 by check or money order (may be combined in the same check as registration fee).
      Toddler - $55; 2Day - $95; 3Day - $130; Multi-Age - $110; PreK - $140


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