Enroll Your Child in Our Montessori Academy Today!

ADMISSION INFORMATION  

Directions: The parent or guardian must fill out this  form entirely  and must return it to the facility no later than the morning of the child’s first day of enrollment. We will keep these forms on file in the facility and will be updated by the parent as needed by SMA to comply with Texas Childcare Licensing Minimum Standards. Forms must be completed in blue or black ink only.  

CHILD’S INFORMATION:  

PARENTS’/GUARDIAN INFORMATION:  

PRIMARY ACCOUNT HOLDER:  

T his parent or guardian will be the main account holder for all the payment information. Any ledger cards, tax forms, and receipts will be in the primary account holder’s name.  

PARENT OR GUARDIAN PRIMARY EMERGENCY CONTACT INFORMATION:

This is the parent or guardian with whom we can get in contact with quickly in case of an emergency.

EMERGENCY CONTACT INFORMATION:  Must be other adult besides the parents or guardians

AUTHORIZED TO PICK UP THE CHILD:  One may be the same as the emergency contact

The authorized pick person must be other adults besides parents.

  ❖  I authorize Sunshine Montessori Academy to release  my child to leave the facility ONLY with the authorized persons listed above. Children will only be released to a parent or guardian or person designated by the parent or guardian after verification of identification.    

AUTHORIZATION FOR EMERGENCY MEDICAL ATTENTION:

In the event I cannot be reached to make arrangements for emergency medical care, I authorize the person in charge to take my child to:

I give consent for Sunshine Montessori Academy to secure any and all necessary emergency medical care for my child and I will be responsible for the applied costs:

MEDICAL INFORMATION:

List any special problems that your child may have, such as environmental allergies, food intolerances, existing illness, previous serious illness, injuries and hospitalizations during the past 12 months and from birth of the child. Any medication prescribed for long-term continuous use and any other information which caregivers and management should be aware of:

Child care operations are public accommodations under the Americans with Disabilities Act (ADA), Title III. If you believe that such an operation may be practicing discrimination in violation of Title III, you may call the ADA information line at (800) 541-0301 (voice) or (800) 514-0383 (TTY).

CONSENT INFORMATION:  Please consent to all that apply

MEALS:

Sunshine Montessori Academy is currently enrolled in the Federal Food Program through the Texas Department of Agriculture and will serve the following meals to your child: Breakfast, Lunch and Afternoon Snack.

SCHEDULE:

Part Time students will need to sign up for the same days each week and will only be able to change or substitute upon director approval. Not all requests will be approved

TUESDAYS:

WEDNESDAYS:

THURSDAYS:

FRIDAYS:

SCHOOL AGE CHILDREN:

My child attends the following school

Authorized Pickup/drop off locations other than the child’s address:

ADMISSION REQUIRMENTS:  

If your child does not  attend pre-kindergarten or school away from Sunshine Montessori Academy, the following must be provided:  

Shot Record: We must receive an updated shot record to be placed in your child’s file every time your child gets a vaccination. If your child is not current with licensing standards, we will not be able to care for your child until they are up to date.  

Physician Statement:  We have provided a physician form for your child’s doctor to fill out and sign to be placed in your child’s file. Form must be filled out completely and a stamp from the doctor’s office included in the designated spot. This form must be submitted within one week of your child’s first day of enrollment.  

Vision and Hearing Screening: The results of your child’s vision and hearing test must be submitted to be placed in their file once your child turns four years old.  

Gang Free Zone:

Under the Texas Penal Code, any area within 1,000 feet of a childcare center is a gang-free zone, where criminal offenses related to organized criminal activity are subject to harsher penalties.

PLEASE FILL OUT THE PHYSICIAN STATMENT AND FOOD ALLERGY EMERGENCY PLAN AND ATTACH THE COMPLETED DOCUMENTS (These are located at the top of this page)  

For Office Use Only:

Date of Enrollment: ___________________ Director: ___________________________

Date of Disenrollment: ________________ Director: ___________________________