Sky Valley Preschool Academy ~ Summer 2010 Registration Parent Authorization for Participation & Medical Release Information - 360-805-9844    *   Enroll Now Space Is Limited! Students will have an opportunity in a variety of learning activities throughout each day. Activities include, writing, phonics, math center, calendar time, letter and sound recognition, science activities, music, crafts, free play, along with a gymnastics class each day. Summer time themes and games.   Students Name:_______________________________________________________________________ Students Birth Date: ________________________________________Age:_______________________ Address:_____________________________________________________________________________ City:______________________________________________________State:_________Zip:_________ Phone:____________________________________________________Cell:______________________ Mothers Names:____________________________________________Phone:____________________ E-Mail_____________________________________________________Cell:______________________ Fathers Name:____________________________________________ Phone:_____________________ E-Mail_____________________________________________________Cell:______________________ Emergency Contact: _______________________________________Phone:_____________________ Authorization for pick up:______________________________________________________________ Allergies:____________________________________________________________________________ Doctors Name:_________________________________Phone_________________________________ Medications:_________________________________________________________________________ Tuition & Classes ( Circle One) ( All field trips are included in fees) Registration Fee $50.00 3 - 4 year olds and Pre K    Mornings Tues & Thurs            9:00 - 12:00 $160.00 per month 3 - 4 year olds and Pre K    Mornings Tues,  Wed & Thurs   9:00 - 12:00 $190.00 per month  2 Days All Day  (Morning Preschool and Summer Camp till 5:00)  $320.00 3 Days All Day  (Morning Preschool and Summer Camp till 5:00)  $380.00 I understand this form legally releases all obligations and responsibilities to Sky Valley Preschool / Gymnastics Academy/Staff / Teachers for the medical treatment of my daughter/son in the event of illness or injury during school and/or school related activity when either parent cannot be reached. If there is any physical or medical reason why he/she should not participate fully at an Sky Valley Preschool Academy event requires a doctor’s release. I also release Sky Valley Preschool Academy / Gymnastics Academy of any and all responsibility due to accident or injury during any type of activity during the school year. I acknowledge that my daughter/ son is enrolled in Sky Valley Preschool Academy and will participate in all school activities. I understand that each child must abide by the rules and regulations set forth by the teachers at Sky Valley Preschool Academy. I have read the rules and regulations and understand them completely. I understand that a violation of any of these rules my lead to temporary or permanent suspension from the school. I must give a 30 day writen notice when discontinuing classes. I am responsibile for tuition from the date of notice to the end of the 30 days.     I give Sky Valley Preschool Academy permission to post or use photos throughout the year on flyers or bulletin boards. Yes__________No_________ Parent/Legal Guardian                      Signature:_________________________________________________Date__________________