Enrollment Form

Personal Information

Child's First Name

Child's Last Name

Child's Date of Birth

Year

Month

Day

Current Day Care / School

Referrer

Medication, Allergies, or Medical Impairments

Address

Parent 1 - First & Last Name

Parent 2 - First & Last Name

Family Information

Parent 1 - Phone Number

Parent 2 - Phone Number

Parent 1 - Email Address

Parent 2 - Email Address

Emergency Details

Emergency Contact 1 - First & Last Name

Emergency Contact 2 - First & Last Name

Emergency Contact 1 - Phone Number

Emergency Contact 2 - Phone Number

Emergency Contact 1 - Relationship to Child

Emergency Contact 2 - Relationship to Child

Media Consent

I grant consent for the documentation of my child's activities through the capture of photos and videos during class sessions as part of their enrollment in Gabby’s Classroom programs. This may include the recording of my child's complete facial features, either individually or alongside peers, as well as specific body segments such as hands, arms, back, or legs. I understand that the captured content may be utilized in social media, advertisements or local posts for Gabby's Classroom. I acknowledge my responsibility to make a specific request if I do not agree with this consent.

Program Consent

I acknowledge that there are certain risks, known or unknown, during class sessions. By enrolling my child in Gabby's Classroom program(s), I have knowingly and voluntarily decided to assume the risks of these inherent dangers in consideration of Gabby's Classroom's permission to allow my child to participate in all programs. I, individually and on behalf of my child, hereby release and discharge Gabby's Classroom from any and all negligence, including building defects, common area liabilities, or Gabby's Classroom's own negligence, in connection with my child's attendance at or participation in the program(s), including travel to and from Gabby's Classroom, except for any gross negligence or willful and wanton misconduct on the part of Gabby's Classroom. I understand that students are expected and required to follow the directions of all teachers and to be respectful towards others. Parents are expected to act on feedback given and be receptive to feedback regarding their child's behavior and participation in the program.

Outdoor Consent

I grant permission for my child to participate in local outings and outdoor learning organized by Gabby's Classroom, including visits to the park. I understand that adequate supervision and safety measures will be maintained. I acknowledge and understand the potential risks, releasing Gabby's Classroom, its staff, and representatives from liability, except for instances of gross negligence or willful misconduct. I also affirm my responsibility for ensuring my child is prepared for outings and understands safety guidelines.

Gabby's Classroom Policies

I agree to follow all of Gabby's Classroom policies and procedures on the website and understand that these will be revised as needed. I acknowledge it is my responsibility to review and adhere to updated policies as they become available.

Parent/Guardian's Full Name

Parent's Signature