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Student Application | SPANISH FOR FUN!

Below is our application to register your child for our daycare / preschool.
Contact the location you are considering (phone number provided) to set your appointment.

SFF! locations and the phone numbers for each:

• Raleigh – Glenwood — 919-881-1160
• Raleigh – Duraleigh — 919-881-1695
• Cary — 919-677-7114
• Wake Forest — 919-881-2063

Application Date

MM slash DD slash YYYY

Requested Date of Enrollment / Starting Date

MM slash DD slash YYYY

CHILD'S INFORMATION

Date of Birth(Required)

MM slash DD slash YYYY

Child's Name(Required)

First Last

Child's Physical Address:(Required)

Street Address City State / Province / Region ZIP / Postal Code

FAMILY INFORMATION

Child lives with:(Required)

1 - Parent / Guardian(Required)

First Last

Cell Phone(Required)

Work Phone

Email(Required)

Address (if different from child’s)

Street Address City State / Province / Region ZIP / Postal Code

2 - Parent / Guardian

First Last

Cell Phone

Work Phone

Address (if different from child’s)

Street Address City State / Province / Region ZIP / Postal Code

ADMISSION REQUEST

Child’s Age

Which location(s) are you applying for?(Required)

Glenwood location (18 months- 5 years)

Duraleigh location (6 weeks - 24 months)

Cary location (6 weeks - 5 years)

Wake Forest location (6 weeks - 5 years)

Which attendance schedule days?(Required)

Monday to Friday

Monday, Wednesday, and Friday

Tuesday and Thursday

How did you hear about us?

CONTACTS / RELEASE INFORMATION:

A child will be released only to the parents/guardians listed above. The child can also be released to the following individuals, as authorized by the person who signs this application. Under no circumstances will SPANISH FOR FUN! Release this child to anyone not identified below without written instructions from the parent. SPANISH FOR FUN! Will not allow a child to enter or leave without an adult escort (18 years or older). Additions or changes to this list must be made in writing. For safety reasons, a valid photo ID must be presented at the front desk before the child is released to the person mentioned herein.

1- Contact / Release Name

First Last

Relationship

Phone Number

2- Contact / Release Name

First Last

Relationship

Phone

3- Contact / Release Name

First Last

Relationship

Phone

EMERGENCY CONTACTS

In the event of an emergency, if the parents/guardians cannot be reached, the facility has permission to contact the following individuals.

1- Emergency Contact

First Last

Relationship

Phone

2- Emergency Contact

First Last

Relationship

Phone

3- Emergency Contact

First Last

Relationship

Phone

OUTDOOR PERMISSION

1. On occasion your child’s teacher will take your child on a nature walk to look, find and explore. Periodically, we block off our parking lot for a bike rodeo and parades. Their teachers, outside of the fenced play area, will guide your child. I give / do not give permission for my child to participate.(Required)

Yes

2. On occasion we will ride your child out of the facility by Buggy as part of the educational program. I give / do not give permission for my child to participate.(Required)

Yes

N/A

HEALTH CARE NEEDS

For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan must be completed by the child’s parent or health care professional. Is there a medical action plan attached?(Required)

Yes

List any allergies and the symptoms and type of response required for allergic reactions. (Type none for no allergies)(Required)

List any health care needs or concerns, symptoms of and type of response for these health care needs or concerns. (Type none for no health concerns)(Required)

List any particular fears or unique behavior characteristics your child may have. (Type none for unique behavior))(Required)

List any types of medication taken for health care needs. (Type none for no medications)(Required)

Share any other information that has a direct bearing on assuring safe medical treatment for your child. (Type none for no other information needed)(Required)

EMERGENCY MEDICAL CARE INFORMATION

Name of health care professional

Phone

Dentist Name

Phone

Hospital preference

Phone

Consent Agreement

I, the undersigned, hereby certify that all information provided in this application is accurate, complete, and provided in good faith. I affirm that I have not knowingly omitted or misrepresented any relevant information.

I acknowledge that SPANISH FOR FUN! has the sole discretion to either accept or decline my application. I hereby release SPANISH FOR FUN! from all liabilities related to personal injury or property damage that may occur on the center’s premises.

I commit to meet all financial obligations to SPANISH FOR FUN! punctually. My signature below affirms my commitment to enroll my child in the school year program, agreeing to make full payments by the 8th of each month. I acknowledge that all REGISTRATION FEES ARE NON-REFUNDABLE. If I choose to withdraw my child from SPANISH FOR FUN!, I will provide a 30-day advance notice.

I agreed to adhere to all policies and procedures outlined in the Parent Handbook provided by SPANISH FOR FUN! In case of an emergency, I authorize the center to seek immediate medical attention for my child as deemed necessary.

Signature or Parent/Guardian

Date

MM slash DD slash YYYY