Child Enrollment information

Child's Name

First Name

Last Name

Parent/Guardian Completing This Form

First Name

Last Name

Parent/Guardian Email

Parent/Guardian Cell Phone

(###)

###

####

I agree to receive text notifications from New World Montessori.

text messages from NW include but not limited to school closings, student emergencies, school news, events and announcements

YES

Sibling Information

Please list child's siblings name, ages and schools

Emergency Contact

Name of person to notify in case of an emergency when parent/guardian is not available

First Name

Last Name

Phone

(###)

###

####

Emergency Contact

Name of person to notify in case of an emergency when parent/guardian is not available

First Name

Last Name

Phone

(###)

###

####

Person(s) Authorized To Call For My Child:

Please list names and phone numbers for any other persons authorized to call for my child.

Medical Release:

Should my child suffer an injury or illness while in the care of New World Montessori School and the school is unable to contact me immediately, 911 emergency services will be called and will be authorized to secure necessary medical treatment and care for the child. I certify that I will be liable for all transportation, medical and hospital expenses incurred in connection with medical treatment.

YES

Child's Primary Source of Healthcare is:

Physician Phone

(###)

###

####

Please list all medical conditions (including drug/food allergies) or other pertinent health information:

Photo Permission:

Photographs may be used in brochures, advertisements, local news media, NWMS events, video, and the New World website and Facebook page. Students are never identified in photos.

YES, I give permission for New World Montessori School to use my child’s photograph (or my family’s photo).

NO, do not use my child’s or family’s photograph.

IMPORTANT NOTE:

Each new student is accepted for a four-week probation period. If he or she is unable to adapt to our classroom procedures or respond to redirection, we may request withdrawal. Parents will be notified immediately if their child is having difficulties, and the staff will make every effort to work cooperatively with each family.

Today's Date

YYYY

New World Montessori School is a non-profit institution and does not discriminate on the basis of race, creed, age, gender, color, national or ethnic origin, sexual orientation, or religion in any aspect of its operations, programs, policies or procedures. I hereby make application for the above named student to be admitted to New World Montessori School.

Please type your name below to complete the application and to have the above named student to be admitted to New World Montessori School