Wellkind

Step 1

To continue with the Enrollment Process, we will need your help in providing all of the necessary information required below.

Relationship to Child/Parentezco con el niño(a):

Primary Contact Name and Last Name /Nombre y Apellido:

Cell-Phone / Telefono Celular

Email/Correo Electronico

Home Address (Street, Number, City, State, Postal Code)/ Dirección de casa (Calle, Numero, Ciudad, Estado, Codigo Postal):

Employer Information / Informacion de Empleador

Work Phone / Telefono de trabajo

Work Address/ Direccion del Trabajo

Relationship to Child/Parentezco con el niño(a):

Secondary Contact Name and Last Name /Nombre y Apellido:

Cell-Phone / Telefono Celular

Email/Correo Electronico

Home Address (Street, Number, City, State, Postal Code)/ Dirección de casa (Calle, Numero, Ciudad, Estado, Codigo Postal):

Employer Information / Informacion de Empleador

Work Phone / Telefono de trabajo

Work Address/ Direccion del Trabajo

Monday

Tuesday

Wednesday

Thursday

Friday

Pick Up Contacts Acknowledgement

I acknowledge that the people listed in Section 4 are emergency contact persons that can, at any time, pick up my child in the event I am unable to do so. / Entiendo que las personas enlistadas en esta sección número 4, son personas de contacto que pueden en cualquier momento, recoger a mi hijo(a) con previa identificación.

Name / Nombre

Phone/ Telefono

Relationship to Child / Parentezco

Name / Nombre

Phone/ Telefono

Relationship to Child / Parentezco

Name / Nombre

Phone/ Telefono

Relationship to Child/ Parentezco

Picture of the Child (Facing the camera)

First day of School

Child's Name

Child's Last Name

Gender

Birthday

Age

Choose One / Seleccione uno

Health Insurance / Seguro Medico:

Policy Number/Numero de Poliza:

Upload Medical Card

Name of Child’s Physician/Nombre del Doctor:

Physician’s Telephone Number/Telefono del doctor:

Physician’s Address/Direccion del Doctor:

Allergies (Including Medication Reaction)/Alergias (Incluya medicamentos)

If your child has an allergy does he/she requiere an EPIPEN?

Special Parent Requests or Dietary Restrictions/ Requerimientos Especiales de los Padres o Restricciones Alimenticias:

Parental Consent for Posting Allergies and Dietary Restrictions:

I grant permission to WellKind School for Early Learners to post information in the classroom about the food allergy, special dietary restriction, or care plan for my Child.

Custody of Child / Custodia del Niño

Add Comments / Añadir Comentarios:

Copy of Custody Order/ Copia de Custodia

Elementary School

My child is not attending Elementary School yet / Mi hijo(a) no asiste a la escuela elemental.

Select your child’s elementary school:

Grade

Transportations Need

Obtaining Medical Care - By signing this you are giving us permission to call 911 if needed. / Obtener Atencion Medica de Emergencia - Al Aceptar, nos autoriza llamar al 911 en caso de emergencia.

Admin First Aid - By signing you are giving us permission to provide minor first aid help for small cuts, bumps, etc. / Administrar Primeros Auxilios - Al Aceptar nos autoriza, administrar primeros auxilios por cortadas, raspaduras, golpes y otros accidentes menores.

Walks and Trips - By signing you are allowing your child to go for outdoor walks. / Caminatas y Excursiones - Al Aceptar autoriza que su hijo (a) vaya en caminatas y/o excursiones.

Transportation by the Facility. By signing you are allowing us to transport your child to elementary school, on a field trip, or in case of an emergency. / Transportacion por WellKind School - Al Aceptar autoriza que su hijo (a) sea transportado a la Escuela Primaria, en Excursiones o en caso de Emergencia.

The use of all media such as the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of above mentioned child can be use in materials that include, but may not be limited to printed materials such as brochures and newsletters, videos, and digital images such as those on the WellKind School for Early Learners website. Child’s personal information will not be used in conjunction with any video or digital images. El uso de media incluyen la demostración, distribución, publicación, transmisión o el uso de fotografías, imágenes y / o videos tomados del niño mencionado puede ser para uso en materiales que incluyen, pero no se limitan a materiales impresos como folletos y boletines informativos, videos e imágenes digitales como los que se encuentran en nuestro sitio web. La información personal de su hijo(a) no se utilizará junto con ningún video o imagen digital.

WellKind School for Early Learners applies a sunscreen product that is broad spectrum with SPF 15 or higher to children, when they go outside during the months of May through October and between the day time hours of 10 a.m. and 4 p.m. Sunscreen may be applied to exposed skin, including but not limited to the face (except eyelids), tops of ears, nose, bare shoulders, arms and legs. Please check below all applicable information regarding permissions and use of sunscreen

If your child currently has an IEP or IFSP, it would be beneficial to share a copy of this plan with us so we can work together to ensure that your child's needs are being best supported0 . Yo do not have to provide this information if you do not wish to do so / Si su hijo tiene actualmente un IEP o IFSP, sería beneficioso compartir una copia de este plan con nosotros para que podamos trabajar juntos para asegurar que la guía se ponga en práctica. No tiene que proporcionar esta información si no desea hacerlo.

Upload a copy of your child's IEP

Picture of the Child (Facing the camera)

First day of School

Child's Name

Child's Last Name

Gender

Birthday

Age

Health Insurance / Seguro Medico:

Policy Number/Numero de Poliza:

Upload Medical Card

Name of Child’s Physician/Nombre del Doctor:

Physician’s Telephone Number/Telefono del doctor:

Physician’s Address/Direccion del Doctor:

Allergies (Including Medication Reaction)/Alergias (Incluya medicamentos)

If your child has an allergy does he/she requiere an EPIPEN?

Special Parent Requests or Dietary Restrictions/ Requerimientos Especiales de los Padres o Restricciones Alimenticias:

Parental Consent for Posting Allergies and Dietary Restrictions:

I grant permission to WellKind School for Early Learners to post information in the classroom about the food allergy, special dietary restriction, or care plan for my Child.

Custody of Child / Custodia del Niño

Add Comments / Añadir Comentarios:

Copy of Custody Order/ Copia de Custodia

Elementary School

My child is not attending Elementary School yet / Mi hijo(a) no asiste a la escuela elemental.

Select your child’s elementary school:

Grade

Transportations Need

Obtaining Medical Care - By signing this you are giving us permission to call 911 if needed. / Obtener Atencion Medica de Emergencia - Al Aceptar, nos autoriza llamar al 911 en caso de emergencia.

Walks and Trips - By signing you are allowing your child to go for outdoor walks. / Caminatas y Excursiones - Al Aceptar autoriza que su hijo (a) vaya en caminatas y/o excursiones.

If your child currently has an IEP or IFSP, it would be beneficial to share a copy of this plan with us so we can work together to ensure that guideliness are put into practice. Yo do not have to provide this information if you do not wish to do so / Si su hijo tiene actualmente un IEP o IFSP, sería beneficioso compartir una copia de este plan con nosotros para que podamos trabajar juntos para asegurar que la guía se ponga en práctica. No tiene que proporcionar esta información si no desea hacerlo.

Upload a copy of your child's IEP

Step 2

Getting to know you!

This information will help your child’s teacher to know more information about your child and your family. Please fill out one form for each child!

Click here to complete “Getting to Know You”

Step 3

Initial Health Report

A Health Report must be signed by a physician, physician’s assistant, CRNP, the Department of Health or a local health department with a copy of ongoing vaccines administered in accordance with the schedule recommended by the ACIP.

Click here to Download “Health Report”

Step 4

Child and Adult Care Food Program Eligibility Questionnaire

Click here to complete “Child and Adult Care Food Program Eligibility Questionnaire”

Step 5

Complete your child's initial ASQ

Download and print the Ages and Stages Questionnaire and Social and Emotional Questionnaire that correspond with your child’s age. Complete this questionnaires to the best of your knowledge and bring them to your child’s first day of school.

Step 6

Explore the Parent Portal! In here you can download our communication app, lunch and snack menus and a list of items to bring on the first day of school.

Explore the Parent Portal!

Within the Parent Portal you will find links to our communication system, important documents and a school calendar with events and closing dates.

Click here and explore the Parent Portal

Step 1

Step 2

Getting to know you!

Step 3

Initial Health Report

Step 4

Child and Adult Care Food Program Eligibility Questionnaire

Step 5

Complete your child's initial ASQ

Step 6

Explore the Parent Portal!

All done!