FBC Preschool Enrollment Form

Please fill out this form and click submit.

***This is the initial registration packet, but there is another packet to complete that is for licensing purposes. This packet is available for pick up at the preschool or at our website fbcmountshasta.com under the Weekday Preschool tab. If you have any questions you can contact Natalie Gilliam at 530-926-5715 or fbcpreschoolms@outlook.com.
Part 1: Student Information

 
 
 
 
Please select one option.
Part 2: Parent/Guardian Information

 
 
 
 
 
 
 
 
 
 
 
Part 3: Enrollment Choice

Please select one option.
Part 4: Medical Requirements

Please select all that apply.
Please bring your child's immunization records.
Part 5: Survey (Optional)

 
 
 
 
Part 6: Signatures

Please select all that apply.
 
 
Permission to Participate in School Activities and to Receive Emergency Care

 
Please select all that apply.

Permission to Participate in School Activities and to Receive Emergency Care


1. I hereby grant permission for my child to use all of the play equipment and participate in all of the activities of the school.
2. I hereby grant permission for my child to leave the school premises under the supervision of a staff member for neighborhood walks or for field trips in an authorized vehicle.
3. I hereby grant permission for my child to be included in evaluations and pictures connected with the school program.
4. I give consent for the following First-Aid measure:
   a. Cleanse cuts, scratches, abrasions with Hydrogen Peroxide, apply antiseptic solution and Band-Aids.
   b. Application of anti-sting solution to insect bites.
   c. Application of ice to bumped or bruised areas.
5. I hereby grant permission to the Director or Acting Director to take whatever steps may be necessary to obtain emergency medical care if warranted. These steps may include, but are not limited to the following:
   a. Attempt to contact a parent or guarding
   b. Attempt to contact the child’s physician
   c. Attempt to contact you (the parent or guarding) through any of the persons listed on the Emergency Information Form you completed for us.
   d. If we cannot contact the parent guardian or child’s physician, we will do any or all of the following:
      i. Call another physician or paramedic
      ii. Have the child taken to an emergency hospital in the company of a staff member.
   e. Any expenses incurred under section (d) above will be borne by the child’s family.
   f. The center will not be responsible for anything that may happens as a result of false information given at the time of enrollment.
   g. The Center will not assume responsibility for a child who has not been signed in when he/she arrives for the day.
 
 
 
 
Admission Agreement

Please select all that apply.

Admission Agreement


1.     I hereby agree to comply with the policies of the First Baptist Church Preschool regarding the collection fee policy, attendance, health and other items specified in the parent’s handbook.


2.     I am aware of the scheduled school holidays.


3.     I understand that I must notify in writing to the FBC Preschool Director of any changes in my employment or residence in case of an Emergency situation may arise.


4.     I agree to notify the school two weeks in advance of withdrawal, should such an event occur, or pay the difference.


5.     I have read, understand and agree to the program policies. Abuse of said policies, may result in to termination of my child’s enrollment.


6.     I understand that no refund of registration fee can be given.


7.     I have completed and returned the enclosed forms.


8.     I have read and understand my Parents Rights and my child’s Personal Rights.


9.     I understand that the FBC Preschool is operated under a California State License; #47038544, issued by: Community Care Licensing


520 Cohasset Rd Suite 170


Chico, CA 95926


(530) 895-5033


10.     I understand that corporal punishment is NOT used as punishment.


11.     I understand that my Monthly fee will be $140/$205 per month and is due before the first working day of the month. Failure to comply may result in termination of enrollment.


12.     I grant permission for the First Baptist Church Preschool to capture and use photographs of my child on their... (check boxes below to agree)
Please select all that apply.
 
 
***This is the initial registration packet, but there is another packet to complete that is for licensing purposes. This packet is available for pick up at the preschool or at our website fbcmountshasta.com under the Weekday Preschool tab. If you have any questions you can contact Natalie Gilliam at 530-926-5715 or fbcpreschoolms@outlook.com.

Description

Please fill out this form and click submit.

***This is the initial registration packet, but there is another packet to complete that is for licensing purposes. This packet is available for pick up at the preschool or at our website fbcmountshasta.com under the Weekday Preschool tab. If you have any questions you can contact Natalie Gilliam at 530-926-5715 or fbcpreschoolms@outlook.com.