Emerald Hills Private School

                  

                   Child enrollment Information     Code Word______________

School________________Grade______Teacher__________­­­__

Child’s Name_______________ Birthdate_________________

 

Name                    Home Address                  Phone

Mother______________________________________________

Father_______________________________________________

Guardian____________________________________________

Work Place Address                                     Phone

Mother_______________________________________________

Father________________________________________________

Child’s Physician_____________________ Phone____________

 

Mau the center call another physician if unable to contact the above? Yes.. Please circle and initial________

Other persons to be notified in case of illness or accident:

        Name                                         Home Address                                     Phone

__________________________________________________________________________

Persons permitted to remove child:  Father   Yes    No

                                                              Mother  Yes    No

__________________________________________________________________________

 

Comments:______________________________________________________________________________________________________________________________________________________________________________________________________________

 

Sig. of person enrolling______________________ Date_______

 

                            

                                                      Emergency Instructions

The purpose of this form is to provide our facility with specific instructions from parents for our staff to follow in arranging for immediate treat of:_______________________

                                                                                                       Child’s Name

 

I,____________________________

AuthorizeEmeraldHillsSchool to seek emergency medical treatment administered but limited to: Paramedics, Hospital emergency room employeesm and other medical professionals as required for emergency medical treatment of my child.

 

Signature:________________________  Date:_____________

 

 

Persons responsible for medical services rendered are:

 

Parent’s Name___________________ Phone _______________

Address_______________________________

 

 

I have the following health insurance:

 

Company name:____________________  Policy #____________

 

 

 

 

 

 

 

 

 

                                                        Discipline Policy

Emerald Hills School will maintain a positive approach when working with your child’s behavior.  We will not use discipline which is humiliating, frightening, or harsh.

Our discipline will not be associated with food, rest, or toileting.  No form of physical punishment will ever be used,

We will encourage positive self-control with teacher support so that the children can learn age appropriate behavior.

 

Your child’s safety and happiness is our  number one concern.

Parents Signature:_______________________

Date:_________

 

 

 

                  Swim Central Water Safety Education  Questionnaire

 

Child Care Facility:____________________    Date:_________

Child’s Name_________________________     Age: _________

 

Parent’s Name and Address:_____________________________

                                                ______________________________

                                                ______________________________

Has your child even taken swim lessons?        Yes___     No___

 

Can your child roll over and float on

his/her Back? Yes___ No__

 

Can your child swim to the side of the pool?  Yes___   No___

Have you taken a Community

Water Safety Course?   Yes___   No___

Is anyone in your household certified CPR?   Yes___   No___

Additional Comment:___________________________________

______________________________________________________

 

 

                           Emerald Hills Private School-Parent Handbook

 

For participation in our private school, it is required that parents registering their children review the following school policies  Parents must sign this agreement acknowledging understanding and acceptance of these terms.

Behavior Policy:  The School reserves the right to discontinue services for behaviors which are disruptive to the operation of the school or pose a safety risk. This policy covers the behavior of participating children as well as parents or any related adults.

Tuition:   All tuition will be paid in full and in advance of services rendered.  Tuition can be paid by check, cash, or credit card.  Any delinquency will result in late fees and in discontinuation of services.  Tuition is due regardless of daily attendance.  Refunds are not made for services paid for but not utilized

Health Forms:  Health forms need to be current and on file before children are permitted to attend school.  These form include the original immunization record # 680 and the school physical # 3040.

Attendance and Punctuality:  Operating hours are between the hours of

7:00 AM and 6:00 PM.  Classes are scheduled to begin at 8:30 AM.  Parents need to notify the school if children will be absent in writing.  There will be a late fee of $10.00 for each fifteen minutes which children are picked up either at the end of VPK classes or after 6:00 PM for our full time students.

 

VPK Class Times:  Classes are offered in two shifts.  Children may be enrolled either for the morning…

8:30 until 11:30 or for the afternoon…12:30 until 3:30.  For families choosing to have their children participate on a full time basis, arrangements may be made for extended care.

Extended care Hours: 7:00AM- 6:00 PM           Initial____   Date______

VPK Documentation of Attendance Form:  An attendance documentation will be completed and returned by participating families each month. 

Sign in Sign out Sheets:  Parents are responsible to sign in, indicating the time children are dropped off, and sign out, indicating the time children are picked up from school.

Lunch:  A well balanced and nutritional lunch may be purchased through the school.  Parents also have the option of providing lunch and snacks.  Please avoid candy, chewing gum, and junk foods.  Also, clearly label your child’s lunchbox

Dress Code:  Please have your child dressed neatly in clothing which is appropriate for school and existing weather conditions.  Closed toe shoes are strongly recommended.  For our younger children, parents should provide a change of clothing- labeled with children’s name.

Personal Possessions:  Children are not permitted to bring toys, cell phones, cd player, or other items which may provide a distraction during school.

Medication:  The school is not responsible for administering any medications  Please do not send medication with your child.

Parent Participation:  We encourage parents to be involved in their children’s educational experience.  Parents need to make arrangements through the school office prior to volunteering

Service understanding:  I understand that I must adhere to the above guidelines for my child to participate in services offered by Emerald Hills Private School

Child’s Name_____________________   Age_______

Parent’s Signature____________________ Date______

Phone Number____________________

 

                                                 Alternate  Nutrition Plan

 

Date:____________      Name of Facility:  EmeraldHillsSchool

                                             Address:   3270 Stirling Rd.

                                              Hollywood Fl.  33021

In accordance with the

BrowardCounty Child Care Ordinance, and the childcare care facility, you are urged to work cooperatively to assure that children are provided with nutritious snacks and meals are not provided by the facility.

 

Please read the following carefully, sign and return:

The facility agrees to provide:         No meals or snacks

The parent agrees to provide:         Mid morning snack

                                                               Lunch

                                                               Mid afternoon snack

I understand that I may purchase a catered lunch:___

 

I have read the above and agree to meet the child’s nutritional needs as defined above:    

                                     Directors Sig:___________________________

                                     Parents Sig:_____________________________

 

 

Child Care Facility

Brochure Statement

Chapter 402.3126.FS

 

on, _____/_____/_____

 

I _________________________________ received a copy of the Child

 

Care Facility Brochure . Parent sig:_______________________.

 

Name of child:________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Child enrollment Information     Code Word______________

School________________Grade______Teacher__________­­­__

Child’s Name_______________ Birthdate_________________

 

Name                    Home Address                  Phone

Mother______________________________________________

Father_______________________________________________

Guardian____________________________________________

 

Work Place Address                                     Phone

Mother_______________________________________________

Father________________________________________________

Child’s Physician_____________________ Phone____________

 

Mau the center call another physician if unable to contact the above? Yes.. Please circle and initial________

 

Other persons to be notified in case of illness or accident:

       

           Name                 Home Address             Phone

 

Persons permitted to remove child:  Father   Yes    No

                                                              Mother  Yes    No

 

 

Comments:______________________________________________________________________________________________________________________________________________________________________________________________________________

 

Sig. of person enrolling______________________ Date_______

 

                             Emergency Instructions

 

The purpose of this form is to provide our facility with specific instructions from parents for our staff to follow in arranging for immediate treat of:_______________________

                                                                                                        Child’s Name

 

I,____________________________

Authorize Emerald Hills School to seek emergency medical treatment administered but limited to: Paramedics, Hospital emergency room employeesm and other medical professionals as required for emergency medical treatment of my child.

 

Signature:________________________  Date:_____________

 

 

Persons responsible for medical services rendered are:

 

Parent’s Name___________________ Phone _______________

Address_______________________________

 

 

I have the following health insurance:

 

Company name:____________________  Policy #____________

 

 

 

 

 

 

 

 

 

                                                              Discipline Policy

EmeraldHillsSchool will maintain a positive approach when working with your child’s behavior.  We will not use discipline which is humiliating, frightening, or harsh.

 

Our discipline will not be associated with food, rest, or toileting.  No form of physical punishment will ever be used,

We will encourage positive self-control with teacher support so that the children can learn age appropriate behavior.

Your child’s safety and happiness is our  number one concern.

 

Parents Signature:_______________________

 

Date:_________

 

 

 

 

 

 

 

 

 

 

         Swim Central Water Safety Education  Questionnaire

 

 

Child Care Facility:____________________    Date:_________

Child’s Name_________________________     Age: _________

 

Parent’s Name and Address:_____________________________

                                                ______________________________

                                                ______________________________

 

 

Has your child even taken swim lessons?        Yes___     No___

 

Can your child roll over and float on

his/her Back? Yes___ No__

 

Can your child swim to the side of the pool?  Yes___   No___

 

Have you taken a Community

Water Safety Course?   Yes___   No___

 

Is anyone in your household certified CPR?   Yes___   No___

 

 

Additional Comment:___________________________________

______________________________________________________

 

 

Swim Central

 

954 N.W. 38^th St.

 

Oakland Park ,Fl. 33317

954 357 8102 (Fax)

 

                                               Emerald Hills Private School

For participation in our private school, it is required that parents registering their children review the following school policies  Parents must sign this agreement acknowledging understanding and acceptance of these terms.

 

Behavior Policy:  The School reserves the right to discontinue services for behaviors which are disruptive to the operation of the school or pose a safety risk. This policy covers the behavior of participating children as well as parents or any related adults.

 

Tuition:   All tuition will be paid in full and in advance of services rendered.  Tuition can be paid by check, cash, or credit card.  Any delinquency will result in late fees and in discontinuation of services.  Tuition is due regardless of daily attendance.  Refunds are not made for services paid for but not utilized

 

Health Forms:  Health forms need to be current and on file before children are permitted to attend school.  These form include the original immunization record # 680 and the school physical # 3040.

 

Attendance and Punctuality:  Operating hours are between the hours of

7:00 AM and 6:00 PM.  Classes are scheduled to begin at 8:30 AM.  Parents need to notify the school if children will be absent in writing.  There will be a late fee of $10.00 for each fifteen minutes which children are picked up either at the end of VPK classes or after 6:00 PM for our full time students.

 

 

VPK Class Times:  Classes are offered in two shifts.  Children may be enrolled either for the morning…

8:30 until 11:30 or for the afternoon…12:30 until 3:30.  For families choosing to have their children participate on a full time basis, arrangements may be made for extended care.

Extended care Hours: 7:00AM- 6:00 PM           Initial____   Date______

 

VPK Documentation of Attendance Form:  An attendance documentation will be completed and returned by participating families each month. 

 

Sign in Sign out Sheets:  Parents are responsible to sign in, indicating the time children are dropped off, and sign out, indicating the time children are picked up from school.

 

Lunch:  A well balanced and nutritional lunch may be purchased through the school.  Parents also have the option of providing lunch and snacks.  Please avoid candy, chewing gum, and junk foods.  Also, clearly label your child’s lunchbox

 

Dress Code:  Please have your child dressed neatly in clothing which is appropriate for school and existing weather conditions.  Closed toe shoes are strongly recommended.  For our younger children, parents should provide a change of clothing- labeled with children’s name.

 

Personal Possessions:  Children are not permitted to bring toys, cell phones, cd player, or other items which may provide a distraction during school.

 

Medication:  The school is not responsible for administering any medications  Please do not send medication with your child.

 

Parent Participation:  We encourage parents to be involved in their children’s educational experience.  Parents need to make arrangements through the school office prior to volunteering

 

Service understanding:  I understand that I must adhere to the above guidelines for my child to participate in services offered by Emerald Hills Private School

 

 

Child’s Name_____________________   Age_______

 

Parent’s Signature____________________ Date______

 

Phone Number____________________

 

                                 Alternate  Nutrition Plan

 

Date:____________      Name of Facility:

EmeraldHillsSchool

                                       Address: 

3270 Stirling Rd.

                                                       

Hollywood Fl.  33021

 

In accordance with the

BrowardCounty Child Care Ordinance, and the childcare care facility, you are urged to work cooperatively to assure that children are provided with nutritious snacks and meals are not provided by the facility.

 

Please read the following carefully, sign and return:

 

The facility agrees to provide:  No meals or snacks

The parent agrees to provide:  Mid morning snack

                                                     Lunch

                                                     Mid afternoon snack

I understand that I may purchase a catered lunch:___

 

I have read the above and agree to meet the child’s nutritional needs as defined above:    

                                     Directors Sig:___________________________

                                     Parents Sig:_____________________________

 

 

Child Care Facility

Brochure Statement

Chapter 402.3126.FS

 

on, _____/_____/_____

 

I _________________________________ received a copy of the Child

 

Care Facility Brochure . Parent sig:_______________________.

 

Name of child:________________________________