Student Enrollment Packet – The Children's Circle – Myers Park United Methodist Church

Student Information

Child's Full Name*

First Middle Last

Goes by*

Address*

Street Address City State ZIP Code

Date of Birth*

Gender*

Sibling Enrolled*

If Yes, Sibling Name and Age

Parent Information

Mom's/Legal Guardian #1 Name*

First Last

Mom's/Legal Guardian #1 Cell Phone Number*

Mom's/Legal Guardian #1 Work Phone Number

Mom's/Legal Guardian #1 Email Address*

Dad's/Legal Guardian #2 Name

First Last

Dad's/Legal Guardian #2 Cell Phone Number

Dad's/Legal Guardian #2 Work Phone Number

Dad's/Legal Guardian #2 Email Address

Emergency Care Information

Name of Child's Pediatrician*

Pediatrician's Phone Number*

Hospital Preference*

Name of Insurance Plan*

ID#*

Subscriber's Name (on insurance card)*

First Last

Parent/Legal Guardian Consent and Agreement for Emergencies

As parent/legal guardian, I give consent to have my child receive first aid by facility staff, and if necessary, be transported to receive emergency care. I understand that I will be responsible for all charges not covered by insurance. I give consent for an emergency contact person listed on this form to act on my behalf until I am available. I agree to review and update this information whenever a change occurs.

Parent's/Legal Guardian’s Signature*

Date*

Medical History

Is your child allergic to anything? (Y/N) If Yes, please describe.**

*For confirmed allergies, please complete the Allergy Alert Form and Action Plan - available on the preschool website.

Does your child have any special conditions or medical issues to be aware of? (Y/N) If Yes, please describe.**

*For special conditions or medical issues, please complete the Special Care Plan - available on the preschool website.

Required Forms - upload online, no paper copies accepted:
1. Annual Medical Form signed by a physician - due by the 30th day of school for child to maintain enrollment at TCC.
2. Current Immunization Record - due by the 30th day of school for child to maintain enrollment at TCC.

Emergency Contacts

To whom child may be released if legal guardian is unavailable

Emergency Contact #1 Name*

First Last

Emergency Contact #1 Phone*

Emergency Contact #1 Relationship*

Emergency Contact #2 Name*

First Last

Emergency Contact #2 Phone*

Emergency Contact #2 Relationship*

Emergency Contact #3 Name

First Last

Emergency Contact #3 Phone

Emergency Contact #3 Relationship

Permissions

TCC Directory*

The Children's Circle Directory, distributed to each family in the fall, is for school family use and may not be reproduced without permission. For the Directory, please select ONE of the two options below:

Photography

I do hereby grant the unlimited right to use and/or reproduce photographs,* likenesses or the voice of my child in any legal manner and for the internal or external promotional and informational activities of The Children’s Circle at Myers Park United Methodist Church. I further understand that by signing this release, I waive any and all present, or future compensation rights to the use of the above stated material(s).

I agree to the Photography policy.

Procare Solutions - Classroom Communication Tool*

I give my child's teachers permission to use my information to provide access to Procare Solutions, which will be maintained by his or her teachers. Procare Solutions is password protected and only for the parents in my child's classroom. This account/app will serve as a communication tool between the teachers and the parents and will include classroom updates and photos of the children engaged in activities and events.

I agree to the Procare Solutions consent.

Class Email List*

I give my child's teachers permission to share my email address with the other families in the classroom. My email address will only be used for the purpose of classroom communications.

I agree to the Class Email List consent.

Parent/Legal Guardian Name*

First Last

Parent/Legal Guardian Signature*

Date*

Potty Training Policies Agreement

Potty Training Policy*

Children in our Toddlers and Twos program are NOT expected to be potty trained. We ask that parents provide disposable diapers as well a complete change of clothes that will remain in your child’s cubby at school. If your child begins the potty training process while in our Toddlers or Twos program, we will partner with you to help with this process within the confines of our busy preschool day.

Children enrolled in our 3s, 4s and TK program MUST BE potty trained in order to attend. Children must be wearing underwear and very rarely having accidents. Please note that wearing pull-ups isn’t considered being potty trained.

Why do 3s, 4s and TK have to be potty trained?
• There are strict standards for changing and disposing of wet or soiled diapers.
• The classrooms are not equipped for diaper changing.
• When an adult is busy changing a child’s diaper or soiled clothing, it is taking away from learning time for all students and it removes one adult from the direct supervision of and interaction with the rest of the class.

A potty-trained child is a child who can do the following:
1. Communicate to the teachers that he/she needs to go to the restroom before they need to go.
2. Alert him/herself to stop what he/she is doing, to go and use the bathroom.
3. Pull down his/her clothes and get them back up without assistance.
4. Wipe him/herself after using the toilet. (With bowel movements as well as urine)
5. Get on/off the toilet by him/herself.

We will certainly offer the opportunity to use the bathroom multiple times throughout the day. We do understand that even potty-trained children will occasionally have toileting accidents, especially when he/she is in a new environment. By definition, "accidents" are unusual incidents and should happen infrequently. In these instances, the teachers will help children to change their clothes, encouraging independence as much as possible.

Please dress your child in clothing that can be undone and changed easily. Please send a complete change of clothes that is appropriate for the season that will remain in your child’s cubby at school. Parents will be notified if a child has a toileting accident.

I have read, understand and agree to the Potty Training Policy of The Children's Circle and will comply to these requirements.

Parent/Legal Guardian Name*

First Last

Parent/Legal Guardian Signature*

Date*

Tuition Policies Agreement

Parent/Legal Guardian Name*

First Last

Parent/Legal Guardian Signature*

Date*

2023-24 Student Enrollment Packet

Student Information

Parent Information

Emergency Care Information

Parent/Legal Guardian Consent and Agreement for Emergencies

Medical History

Emergency Contacts

Permissions

Potty Training Policies Agreement

Tuition Policies Agreement