Enrollment Requirement Check-list
The following information is required for new enrollment acceptance. You can
pick up the registration information at our preschool office during business
hours. Waiting List: If we have a waiting list for a program you desire, we will
put your registration packet in the date order it is received. We will contact
you one-week prior to an open placement for your child.
1. Enrollment Application
2. Identification/Emergency Information (LIC 700)
3. Child’s Pre-Admission Health History (LIC 702)
4. Consent for Emergency Medical Treatment (LIC 627)
5. Physician Report (LIC 701) (must be submitted before 30 days after child
6. Personal Rights (LIC 613A)
7. Parent’s Rights (LIC 995)
8. Enrollment Agreement (back of parent handbook)
9. Copy of current Immunization Record (we will make a copy for you)
One-time $100.00 per child (non-refundable) registration fee
After first year of enrollment a $30.00 per child (non-refundable)
Summer Activity Fee:
$30 for summer program
Required Immunizations and T.B. Test
The following immunizations and T.B. test are required by the State of
California, Department of Social Services prior to admission to the preschool.
The T.B. test must be dated no more than 12 months prior to admittance.
___ 3 Polio Vaccinations
___ 4 DPT Vaccinations
___ 1 MMR Vaccination
___ 3 HIB Vaccinations
___ 3 Hepatitis B Vaccinations
___ 1 Varicella (Chicken Pox) Vaccine
___ 1 T.B. Test (negative result)
Immunizations must be current.
First Day of School Requirement:
- Change of clothes (underwear, pants, shirt) in Ziploc bag
- Earthquake Kit (see back of parent handbook)
- Full-Day child: Sheet, blanket & small pillow (name on all) Put items in a
small backpack or pillowcase with child’s name on it.
- Two-weeks tuition (see payment schedule)