Les Enfants De Seattle

Registration Form

Name of Child: ______Birthday:______

Address:______

# Street City Zip

First Parent/Guardian:

Home Phone Number:______Work #:______Cell: ______

E-mail address:______

Second Parent/Guardian:

Home Phone Number:______Work #:______Cell: ______

E-mail address:______

Other People to notify in case of an emergency:

Name:______Relationship:______Phone #:______

Other than you, who has permission to pick up your child:

Name:______Address:______Phone #:______

Are there any special issues, including medical, that we need to know about your child?

Are there any foods that need to be restricted to your child?______

Name of Insurance Company:______Policy #:______

Name of Policy Holder:______

X______

Signature of Parent/Guardian

Permission Form

During my child’s tenure at Les Enfants de Seattle

Student’s Name:______

1. Medical Care & Treatment of a Minor Child

I hereby give permission to any staff member of Les Enfants de Seattle to administer first aid/medical treatment to my child or/and transported to a hospital for emergency medical or surgical treatment.

2. Applying Sunscreen

I hereby give permission to the staff of Les Enfants de Seattle to put sunscreen during the course of his/her stay at summer camp and during the school year as is reasonable.

3. Field Trip Permission

I hereby give my permission to the staff of Les Enfants de Seattle to take my child on field trips, and/or neighborhood walks by means of walking, bus or private car. The school will notify parents in advance about upcoming field trips.

4. Photographs

I hereby give my permission to Les Enfants de Seattle to photograph my child individually or in a group for publicity purposes and/or school activities, including school’s website and various school publications. I relinquish all rights, title and interest in the finished product.

5. School Directory

I hereby give my permission Les Enfants de Seattle to include our family name, home address, home phone number, home e-mail address and my child’s name in the school’s directory (for private use only).

Parent or Guardian Signature:______Date:______