Child's Full Name* First Middle Last Is your child enrolled at WPELC for the 2023-2024 school year?* Yes No Child's Class*Select Your Child's ClassParent-Tot – WednesdayParent-Tot – ThursdayEarly Learner – T/ThEarly Learner – M/W/FPreschool – T/ThPreschool – M/W/FDo you have another child enrolled at WPELC for the 2023-2024 school year?* Yes No Please list the name(s) and class(es) for any siblings enrolled at WPELC for the 2023-2024 school year who are covered under this release.*You only need to complete this form once per family if all children have the same preferences. Parent / GuardianName* First Last Email* Does this child have a second parent/guardian?* Yes No Name* First Last Email* Neighborhood Exploration InformationOur students may take Neighborhood Explorations as a class, off school grounds throughout the year. Examples include: walking around the block, heading over to Washington Park, observing construction in the neighborhood, working in the school garden, etc. Parents will be notified when these explorations occur. Teachers and staff will bring first aid kits, appropriate student medications, and family contact information whenever offsite. Please be sure your child is dressed appropriately for weather and walking. By signing this release, I allow my child to participate in WPELC Neighborhood Explorations. I hereby release and save harmless Washington Park Early Learning Center and any and all of its employees, agents and volunteers from any and all liability for any and all harm arising to my child as a result of these trips. I assume full responsibility for the actions of my child while participating in these trips. I have read this release and understand all its terms and execute it voluntarily and with full knowledge of its significance. Policy and procedures concerning Neighborhood Explorations can be found in the WPELC Parent Handbook.Neighborhood Exploration Consent*My/our child may participate in WPELC Neighborhood Explorations. Yes No Emergency Medical Treatment*In the event of an emergency and we cannot be contacted, I hereby authorize that emergency treatment may be administered. Yes No SignatureParent/Guardian Signature*The consent given by this form is valid for the period of August 15, 2023 to August 14, 2024.Second Parent/Guardian Signature*The consent given by this form is valid for the period of August 15, 2023 to August 14, 2024.HiddenSignature Date MM slash DD slash YYYY
