Enrollment

Thank you for choosing to enroll your student in Kid's Club. Enrollment begins July 2022.
You can either apply online or download a hard copy of the enrollment forms and submit them at the Kid's Club office at Life School.

ONline Enrollment

PARENT PORTAL

When is your child's first day at Kid's Club?

Mother First Name

Mother Last Name

Mother Email

Mother Address

Address

Country

City

State

Zip/Postal Code

Home Phone Number

Cell Phone Number

Father First Name

Father Last Name

Father Email Address

Father Address

Address

Country

City

State

Zip/Postal Code

Home Phone Number

Cell Phone Number

Child's Living Arrangements
Both Parents
Mother
Father
Other (Specify)

(If Other) Who is the Child's Legal Guardian?

Child's First Name

Child's Last Name

Date of Birth

Child's Gender
Male
Female

Child's Grade

Number of days your child will attending (choose all that apply)
Full-Time (3-5 days a week)
Part-Time (1-2 days a week)

Are your records on file
My child’s immunization record is on file at the school and all required immunizations and/or tuberculosis test are current. Vision and hearing screening records are also on file.
Still need to Test and/or give results to file.

Permission for your child
My child has permission to be released to the care of his/her sibling(s) that is between the age of 13 to 18 years old.
My child does not have permission

Name of Sibling(s)

Age:

Whom should we contact when Parent/Guardian is not available? Please designate each person as an Emergency Contact, Authorized Pick Up, or both and their relationship to the child, along with telephone number. Children will only be released from the premises with a parent/guardian or a person designated by the parent/guardian after verification of ID.

Authorized First Name

Authorized Last Name

Authorized Phone Number

Relationship to Child

Authorization
Emergency Contact
Authorized Pick-Up

Authorized First Name

Authorized Last Name

Authorized Phone Number

Authorization
Emergency Contact
Authorized Pick-Up

Authorized First Name

Authorized Last Name

Authorized Phone Number

Relationship to Child

Authorization
Emergency Contact
Authorized Pick-Up

In the event I cannot be reached to make arrangements for emergency medical care, I authorize the person in charge to take my child to:

Name of Physician

Physician Phone Number

Physician Address

Address

Country

City

State

Zip/Postal Code

Emergency Facility

Emergency Facility Phone Number

Emergency Facility Address

Address

Country

City

State

Zip/Postal Code

Consent
I give consent for the Kid's Club facility to secure any and all necessary emergency medical care for my child.

Signature of Parent or Legal Guardian

List any special needs/problems that your child may have such as ADD, ADHD, Autism, allergies, existing illness, previous serious illness, disabilities, injuries and hospitalizations during the past 12 months, any medication prescribed for long-term continuous use, and any other information which caregivers should be aware of:

Kid's Club communicates to parents in several different ways: face to face, notices sent home, by telephone, email and text messaging. Please be sure we have your correct information so we may communicate with you effectively.

Phone Number

Network Carrier

Email Address

Is your student in foster care?
Yes
No

If student is not in foster care, images of student may be captured during regular and special activities through videos and photographs. Videos and photographs will be used solely for the purposes of promoting Kid's Club through flyers, publications, social media, and/or our website.

I understand that tuition is auto drafted the first of each month for the upcoming month of child care and I am responsible to pay for the amount charged regardless of attendance to reserve my child’s spot. I understand that failure to pay could result in automatic withdrawal from Kid's Club and my spot given to a family waiting for care.

Electronic Signature of Parent or Legal Guardian *

Date

Submit

NOTICE OF NONDISCRIMINATORY POLICY AS TO STUDENTS

Covenant Kids Club admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered programs.

Enrollment

Thank you for choosing to enroll your student in Kid's Club. Enrollment begins July 2022.You can either apply online or download a hard copy of the enrollment forms and submit them at the Kid's Club office at Life School.

Thank you for choosing to enroll your student in Kid's Club. Enrollment begins July 2022.
You can either apply online or download a hard copy of the enrollment forms and submit them at the Kid's Club office at Life School.