Summer Enrollment Form Summer Enrollment Form Summer Enrollment Form Starting Line Preschool Summer Enrollment Form Student (s) Information Name * First Name Last Name Age Birthday Please chose the days attending and either half or full day option June 3- 6 Half Day Full Day June 10-13 * Half Day Full Day June 17-20 Half Day Full Day June 24-27 Half Day Full Day July 8-11 Half Day Full Day July 15-18 Half Day Full Day July 22-25 Half Day Full Day Mother's name * First Name Last Name Phone * (###) ### #### Email * Father's name First Name Last Name Phone * (###) ### #### Email * Home Address * Any Medical Conditions We Should Know About . (Food Allergies, ETC) * In case of an Emergency, other than parents whom may we contact? * Phone * (###) ### #### Release All precautions will be taken to prevent accidents while your child is in class. Simple first aid will be administered to all minor injuries; parents or doctors will be notified when necessary. I hereby consent to have my child participate in programs offered by the Starting Line Preschool and their employees. It is hereby agreed that I, my child, my heirs and executors, waive and release all rights and claims for damages that I may have at any time against the Starting Line Preschool, their employee’s, and its representatives, whether paid or volunteer, for any injury or damages in connection with the Starting Line program. The risks involved in respect to such a program are fully understood. Name * First Name Last Name Thank you!