Cooperative Preschool Registration Form

Cooperative   P reschool   R egistration   F orm  

Keep the yellow copy of this form for your records. Mail the white copy to the membership chairperson listed below:

Return   t o:  

Name   o f   s chool   _ Wapato   C ooperative   P reschool_________Membership   c hairperson__Hitomi   A llen___________________________  

 

Mailing   A ddress_5236   E   B   s t,   T acoma   W A   9 8404   _ _____________________________________________Phone:_253-­‐271-­‐8442____

Child’s   n ame   (

  D ate   o f   b irth   _ ____________Age   _ ______Sex   _ _M               F _____    

last/first/name   u sed)______________________________________________

 

 

 

Home   a ddress  

( inc.   z ip   c ode)  __________________________________________________________________________________________________________________  

 

 

 

 

 

 

 

 

 

 

 

 

 

Home   P hone____________________   C ell   P hone_________________________   E   M ail   _ __________________   _ ______________________  

 

Parent/guardian   n ame(s)   ( last,   f irst)  

 

 

                                                                                  ( last,   f irst)  

 

 

Parent/guardian   o ccupation_______________________________________________Employer  

 

 

Interests__________________________________________________________________Preferred   P hone   #  

 

 

AGREEMENT   B ETWEEN   P ARENT(S)/GUARDIAN(S)   A ND   P RESCHOOL  

I   ( we)   u nderstand   t hat   t his   i s   a   p arent   p articipation   p reschool   c oordinated   b y   B ates   T echnical   C ollege,   C hild   S tudies   D epartment.    

I   ( we)   f urther   u nderstand   t hat   t he   m ain   p urpose   o f   t his   p rogram   i s   p arent   e ducation   i n   c hild   d evelopment   a nd   t hat   t he   p reschool’s   s uccess  

depends   u pon   t he   p articipation   a nd   s haring   o f   r esponsibilities   b y   a ll   f amilies.  

As   a   p arent/guardian   i n   _ _______________________________________   C ooperative   P reschool,   I   ( we)   a gree   t o   f ulfill   o ur  

participation   a nd   r esponsibilities   i n   t he   f ollowing   w ays:  

Pay   r equired   f ees:   S chool   R egistration   ( nonrefundable)   –   B ates   R egistration   F ee   –   P reschool   T uition   –   a nd   o ther   f ees   a s   r equired   b y   o ur   s chool.  

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                A MOUNT   D UE   W ITH   F ORM___________________   I NCLUDES_______________________________________________________  

 

Attend   a   m inimum   o f   1   p arent   e ducation   o pportunity   f or   e very   m onth   t he   f amily   i s   e nrolled,   w hich   m ust   i nclude   O rientation   a nd   P arent   T raining.  

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Work   i n   t he   c lassroom   a s   a n   a ssistant   o n   m y   a ssigned   d ays   a nd   t ake   r esponsibility   f or   p roviding   a   t rained   s ubstitute   w hen   n ecessary.  

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Provide   a   n utritious   s nack   f or   a ll   c hildren   o n   m y   a ssigned   d ay   o n   a   r otating   b asis   u nder   t he   d irection   o f   t he   t eacher.  

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Keep   m y   c hild   a t   h ome   i f   t here   a re   s igns   o f   a ny   c ommunicable   d isease.  

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Volunteer   f or   a   b oard   p osition   o r   a   c ommittee   p osition.  

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Participate   i n   f undraising   a ccording   t o   s chool   g uidelines.  

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Complete   a nd   s ubmit   a ll   f orms   r equired   b y   t he   s chool   i ncluding   I nformation   F orm,   C onsent   f or   E mergency   M edical   a nd   S urgical   C are,   a nd   C ertificate   o f  

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Immunization   o r   C ertificate   o f   E xemption,   B ates   R egistration   f orm   a nd   C hild   R elease   f orm.  

 

I   g ive   p ermission   f or   m y   c hild   t o   p articipate   o n   s upervised   f ield   t rips   t hroughout   t he   s chool   y ear,   b y   f oot   o r   c ar,   a s   n otified   b y   t he   s chool.  

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Fulfill   d uties   a ssigned   e qually   t o   a ll   f or   t he   u pkeep   o f   t he   s chool   f acilities.  

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Allow   m y   c hild   t o   b e   v ideotaped   a nd/or   p hotographed   d uring   c lass   a ctivities   f or   e ducational   p urposes.  

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By   s igning   t he   p ortion   b elow,   I   ( we)   a re   w illing   t o   m eet   t he   a bove   r equirements   a nd   t o   a bide   b y   t he   c onstitution,   s tanding   p olicies  

and   h andbook   o f   t he   s chool.  

 

Mother/guardian’s   s ignature_______________________________________   F ather/guardian’s   s ignature_____________________________________  

                 

Child’s   C lass___________________________________________________           D ate:___________________________________                    

 

B TC   – 1   R ev1/5/2016