BASC Drop-In Childcare Form 2012-2013.doc - cemcs-2026

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The document outlines the registration and consent form for the Drop-In Child Care program at Casa Esperanza Montessori, a dual-language charter school. It includes details on childcare fees, student information, parental consent, emergency medical treatment authorization, and pick-up authorization for children enrolled in the program.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the Student Information section. Enter the last name, first name, gender, date of birth, age, grade level for the academic year, and teacher's name.
In the Parent/Guardian Consent Form section, provide details for both parents or guardians including names, occupations, emails, and daytime and cell phone numbers.
Complete the Emergency Medical Treatment section by entering your child's name and providing information about your family doctor and any medications that staff should be aware of.
List individuals authorized to pick up your child in the Authorization to Pick Up the Child section. Include their names and phone numbers.
Finally, review all entered information for accuracy before signing at the bottom of the form. Ensure you print your name and date as well.

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