Parental Agreement

Child's Name
First Last
Parent 1 Name*
First Last
Parent 1 Email*
Parent 2 Name
First Last
Parent 2 Email
Parental Agreement
•As required by Virginia law, I will submit a complete medical form with immunization records to the School prior to my child’s first day. I will also show proof of my child’s identity by bringing my child’s original Birth Certificate or Passport to the School.

•I agree to come promptly if notified that my child is sick. If I am not going to be available on any given day, I will inform the School of a contact person in case of illness.

•I agree to provide the School with the names of all individuals authorized to pick up my child in case of an emergency when the parent(s) cannot be reached.

•I authorize the staff at the School to give or authorize emergency medical treatment for my child if an emergency occurs and I cannot be immediately contacted.

•I agree not to hold the School or its employees liable in case of an accident involving my child.

•I understand that my child will not be released to anyone other than a parent unless the School is given written permission.

•I agree to provide the School with any names of individuals who are legally prevented from interaction with my child.

•I grant my child permission to participate in the field trips to the gym for activities and/or music on any given day and/or time. If I choose to withdraw my child from participating in the "Field Trip" to the gym on any given day or time then I will let my child's teacher know.

•I agree to provide a healthy, nutritious, nut-free snack and lunch (if staying) for my child on a daily basis. I agree to pick up my child on time each day.

•I understand that children who are not picked up on time will go to extended care and parents will be charged $5 for every 5 minutes their child remains in extended care.

•I agree that if my child is enrolled in extended care, I will pick him/her up at the designated time. Parents who are late to pick up their child will be charged $5 for every 5 minutes their child remains in care at school.

By checking this box, you are agreeing to the statements above.*

I agree

Signature*

Date*

I agree to let my child be photographed at CDS. I understand that the photographs will be used for reasonable CDS purposes including publication on CDS websites, CDS social media accounts, printed ads and publications.*