Bright Start of Colorado

Preschool and Childcare

1880 Willow Park Way Monument, CO, 80132 United States

(719) 339-6044

 

At Bright Start, our staff is dedicated to helping your child build the best foundation for their future. We focus on pre-academics as well as the social and physical growth of every child. We believe that children should be nurtured and supported in their early childhood educational experience so they may obtain confidence and pride outside the home. Using Developmentally Appropriate Practices we meet each child at their current level and help build their foundation from there. We practice positive modeling, encouraging reinforcement, and consistent classroom rules. Parents are an integral part of the learning process, and we will work as a team to meet the needs of your children. We look forward to learning with you, because great futures begin with a Bright Start!

Start Date___________

 

Bright Start Preschool and Child Care

Application for Admission

 

Child’s Name___________________________________________Birthday (M/D/Y)____________

Address_________________________________________________________Sex_____________

 

Comments_______________________________________________________________________

_________________________________________________________________

 

Program:  Morning Session  Afternoon Session  Full Day    2 Days  3 Days  4 Days  5 Days

Previous school attended: _______________________________________________

Parent Information

Parent or Guardian Name ___________________________________ Cell Phone________________

Home Phone __________________Email __________________Alternate Contact_______________

 

Address___________________________________________________________________________

 

Employer________________________________________________Work Phone________________

 

Employer Address___________________________________________________________________

 

Parent or Guardian Name ____________________________________Cell Phone________________

Home Phone __________________Email __________________Alternate Contact_______________

 

Address___________________________________________________________________________

 

Employer________________________________________________Work Phone________________

 

Employer Address___________________________________________________________________

 

Special instructions of how to contact (e.g. what number/email to try first if we need to contact you during business hours.): ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Physician Information

 

Name_________________________________________________Phone___________________

 

Address__________________________________________________________________________

 

Dentist___________________________________________________Phone___________________

 

Address__________________________________________________________________________

 

Hospital Preference_________________________________________________________________

 

Authorization for Emergency Medical Care

I understand that I will be notified at once in case of accident or illness to my child, and I will make arrangements for medical care of my child with the physician or hospital of my choice. If I cannot be reached to make necessary arrangements, or in a critical emergency requiring medical care, I hereby authorize Bright Start Preschool and Child Care to contact the above Physician/Hospital.

 

Parent/Guardian Signature _____________________________________Date_______

 

 

 

 

Emergency Contacts if parents are not able to be contacted

 

Name________________________________________ Phone ________________________________

Address______________________________________ Relationship to Child_____________________

Name________________________________________ Phone ________________________________

Address______________________________________ Relationship to Child_____________________

Name________________________________________ Phone ________________________________

Address______________________________________ Relationship to Child_____________________

If you want to arrange for another person to pick up your child, please notify the staff preferably in writing.

 

 

Allergies____________________________________________________

Reaction____________________________________________________

Treatment___________________________________________________

 

Model Release

I  do  do not give consent for photographs of my child to be used in the Bright Start Preschool and Child Care web site and/or in print advertising for the school.

Field Trip Release

I  do  do not give consent for my child to attend field trips with Bright Start Preschool and Child Care.  I will be notified in advance when field trips will occur.

Directory Release

I  do  do not give consent for my child’s name, address, and phone number to be included in the Bright Start Preschool and Child Care. (This directory is distributed only to Bright Start Preschool and Child Care families.)

 

Agreements

(A) I have been informed that parent/teacher conferences are held at regularly scheduled intervals. (B) When my child is ill, it is understood and agreed that he/she may not be accepted into care. (C) I have read and accept this facility’s policies pertaining to admission, care, and discharge of children. (D) I have been informed that a copy of licensing rules for child day care centers in Colorado is available in the office for review. (E) I am aware that there will be a $100 fee if I choose to withdraw my child. I have been informed that a one month written withdrawal notice is required. (F) I have read and accept this facility’s policies pertaining to payment of tuition. (G) I will keep Bright Start Preschool and Child Care updated on any address, phone, or work number changes.

 

Parent/Guardian Signature _____________________________________Date_______