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Parent 1 Name
Parent 1 Email
Parent 2 Name
Parent 2 Email
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.
Date Format: MM slash DD slash YYYY
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 and yearbook.
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