Resurrection Lutheran Church
(405) 354-3322
Yukon, OK
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Ready to Enroll Your Child? Let's Get Started!

Resurrection Kids Registration

RLC Kids Registration Form

r_kids_registration_applic.pdf
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File Type: pdf
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r_kids_regis_applic.docx
File Size: 48 kb
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Resurrection Kids Childcare Compliance Disclosure

compliance_file_notification.pdf
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SAMPLE Resurrection Kids Registration Form

Resurrection Kids
A Ministry Outreach Program Supported by Resurrection Lutheran Church
675 W Vandament, Yukon, Ok 73099
(405) 354-3721   kim@rlcok.org or samantha@rlcok.org

­­­________ $100.00 Non-Refundable Registration Fee
________ Submit a current copy of Immunization record
 
Monday/Wednesday/Friday (Based on child's age as of Sept.1)
Kids Day Out: 12-24 months (2 days required)
Preschool and Pre-K :3, 4 and 5 year olds (3 days required)

Circle hours desired:
Hours and Tuition:
8:30am-4:00pm  Tuition: $29.00 per day                                     
9:30am-3:00pm Tuition: $23.00 per day

Desired School Days:
Monday/Wednesday/Friday
(1 & 2 yr old classes only)   ____Mon ____Wed ____Fri  
 
Tuesday/Thursday: Kids Day Out: 
(18-35 months)   ____Tues ____Thurs
(3-5 years)           ____Tues ____Thurs

Add-on Option: 
​Before Care
$5.00/day  (8:00am- 8:30am)          ____Mon ____Tue ___Wed ____Thurs ____Fri      
 
Student’s Name_________________________________________________________________
 
Age_________ Birthday__________________ Male____ Female____
 
Address: ___________________________________City___________________Zip___________
 
Best Contact Telephone Number___________________________________________________
 
Email Address___________________________________________________________________
 
 
Emergency Contact Number (other than parents) ______________________________________
 
Name__________________________________ Relationship_____________________________
 
 
Persons authorized to pick up your child _____________________________________________
 
______________________________________________________________________________
______________________________________________________________________________

Resurrection Kids Christian School Enrollment Form 2020/2021
Safety Code: ___________________________

​The Remind App will be used for classroom and program communications via cell phone. You will receive a text prior to our open house.  Call if you have questions, 405-354-3721.

Father’s Name: ____________________________Occupation:___________________________
Cell #________________________
Mother’s Name: ___________________________Occupation:__________________________                                                         
Cell #_________________________               
Siblings and their ages____________________________________________________________
______________________________________________________________________________
 
First time in a child care program? ____Yes ____No
 
Allergies/Reactions:______________________________________________________________
                                                                                                                                               
Serious Illness: __________________________________________________________________
 
 
Potty Trained (mark all that apply):  _____Yes _____No           _____Goes on their own
​_____Wipes _____Washes hands _____Can pull up pants _____ button pants _____zip pants
 
 
Nap Habits: _____Rests easily _____With some assistance _____Does not nap
 
 
Attention Span Habits:
(
There are no incorrect answers. Knowing your child helps us to place him/ her in the correct class.)
 
Likes to be read to: ____ Yes ____Sometimes ____Not really
 
 
Likes to Color: ____Yes ____Sometimes ____Not really
 
 
Stays focused on any given task: (Puzzles, blocks, play-doh) ____2 Min ____5 Min ____10 Min
 
 
Socialization Habits: (mark all that apply)
 
____Plays rough ____Generally shares ____Can take turns ____Likes to play with others
 
____Plays well alone ____Affectionate

General Health Agreement:

Please do not expect our program to take care of sick children. If your child has a fever (100 degrees or higher), is vomiting, has diarrhea, an ear ache, sore throat, skin eruptions (rash, boils, ringworm, impetigo etc.) constant cough, red or runny eyes, runny nose with colored mucus, an acute cold, a respiratory infection, or in general feels “icky”---PLEASE keep your child at HOME!

Children should be free of all the above described symptoms for at least 24 hours, without the use of fever/pain suppressants, before returning to school. If children become sick during the school day, we will notify you to come pick them up. We will make sure your child is as comfortable as possible as they await your arrival.
 
NIT FREE is our policy; therefore if we suspect head lice we will contact you immediately to come get your child. A child must be nit free for at least 48 hours before returning to school.
 
I have read the above and will honor the program’s health policies.
 
Doctor’s Name _____________________________________ Phone #______________________
 
 
Signature_______________________________________________Date___________________
 
 
Emergency Treatment Release
 
In the event of an illness or accident that requires immediate medical treatment at a time when a parent/guardian cannot be reached, I give permission for Resurrection Kids to provide such emergency treatment to the best of their knowledge and ability. I will not hold the program or medical personnel responsible. This is done with the understanding that every attempt will have been made to contact a parent/guardian and other persons listed as emergency contacts.
I authorize staff members who are trained in the basics of first aid and CPR to administer the needed care to the best of their abilities. In the event of an illness or accident that poses imminent danger (seizure, head injury etc.) Resurrection Kids staff will call 911, for professional treatment. Every attempt will be made to contact a parent/guardian or a designated emergency contact.
 
Signature_____________________________________________Date_________________
 
 
Publish Request
 
I here-by give Resurrection Lutheran Church/Kids the absolute right and permission to publish, copyright and use pictures of my child/myself for the purpose of promoting the ministry programs of Resurrection Lutheran Church/Kids. I understand that no names will be used to identify children without the expressed permission of parents.
 
 
Signature____________________________________________Date_____________________
 
Discipline Policies:
 
A positive, welcoming atmosphere is maintained in the program. All children are welcomed and secure. If there is a need to correct or redirect a child’s behavior, the methods used are not humiliating, frightening, or physically harmful to the child. Discipline is based on the child’s level of understanding and directed toward teaching the child acceptable behavior. If a “time- out” or “thinking time” is used, their age is taken into consideration; (i.e. 1 minute per year of age.)
If a child insists on behavior that is unacceptable, disturbing or harmful to others, parent(s) will be contacted, and possibly asked to take their child home for the remainder of the day.
 
Biting policy: Due to the seriousness of a bite injury, the program is required to enforce a strict policy to ensure the safety of students and staff. The following school procedures are for children who bite another student or a staff member.
-First and Second incident: parents are notified and asked to pick up the child immediately.
-Third incident: parents are notified and asked to pick up the child immediately and the child will be expelled from school for two weeks.
-Fourth incident: Parents are notified and asked to pick up the child immediately and the child will be expelled from school for the remainder of the semester. Parents may pay 50% of tuition to hold the child’s classroom slot so that he/she will have the opportunity to return at semester change.
 
I have read the above and will honor the program’s discipline policies.
 
 
 
Signature____________________________________________Date______________________
                                                                                                                                                                                     
 
Financial Policies
 
There is a non-refundable registration fee of $100.00 per student. This fee accompanies your enrollment form to reserve space in our program.
 
Tuition is $23/$29 per day and is due the first week of every school month. A $10 late fee will be added to tuition if received after the due date; additional late fees of $10 per week will accrue if tuition is more than one week late.
 
Before care and after care fees are $5.00 per session.
 
Parents/Guardians are responsible for reimbursing the program a $30 NSF charge due to a returned check.
 
 
I have read the above and will honor the program’s financial policies
 
 
Signature_____________________________________________Date____________________