Village Montessori School
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Programs
Toddler Program (16 - 36 months)
Primary Program (3 - 6 years)
Elementary Program (6 - 12 years)
Middle School Program (12 - 15 years)
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Emergency Information Form
Student's Name
*
First
Last
Birthdate
*
Gender
*
Home Address
*
Home Phone
*
Email
*
Parent/Guardian 1 Name
*
Parent/Guardian 1 Occupation
*
Parent/Guardian 1 Cell Number
*
Parent/Guardian 1 Work Number
*
Parent/Guardian 2 Name
*
Parent/Guardian 2 Occupation
*
Parent/Guardian 2 Cell Number
*
Parent/Guardian 2 Work Number
*
Child's Doctor
*
Doctor Phone Number
*
Child's Dentist
*
Dentist Phone Number
*
Allergies
*
write 'none' if no known allergies
Current Prescribed Medications
*
if none, write 'none'
Special Needs and Conditions
*
If none, write 'none'
If unable to reach parent/guardians, call
*
name and number
If unable to reach parents/guardians call
*
name and number
Person 1 authorized to pick up my child from school
*
First
Last
[object Object]
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Person 2 authorized to pick up my child from school
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Additional persons authorized to pick up my child from school (address and phone number required)
*
*
Indicates required field
By typing my name below, I agree to the following statement: In the event of an emergency involving my child, and if Village Montessori School cannot get in touch with me, I hereby authorize any needed emergency medical care. I further agree to be fully responsible for all medical expenses incurred during the treatment of my child.
*
By checking yes, I authorize my signature and agree to the terms and conditions above
*
Yes
Submit
Home
Programs
Toddler Program (16 - 36 months)
Primary Program (3 - 6 years)
Elementary Program (6 - 12 years)
Middle School Program (12 - 15 years)
About
Why Montessori
Vision
Mission
Our Staff
Testimonials
Resources
Calendar
Lunch Ideas
Parent's Corner
>
Parent Handbook
Class Directories
Apogee Scholarship
Montessori Reading
Covid-19 Plans and Procedures
Forms and Handbooks
Admissions
Application for Enrollment
Contact
Schedule a Tour
Employment Opportunities
Parent Association
Welcome to the Parent Association
Your Role
Parent Association Volunteer Form
PA Volunteer Sign Up