Utah State Health Authority - Proof Of Immunizations

    1. A valid Health Certificate issued by the Child's Pediatrician must be forwarded and filed with
        the Montessori School of Salt Lake Inc. at the time of a Child Enrollment.
    2. State Health Authority requires Child Care providers to be 'current' with ALL certifications on file.
   3. Parents must provide any 'Certifications that have been Renewed' during the course of time,
       to help the school maintain updated Records for review by the Health Authotities at any/all times.
4. All information in the children's personal files trusted to the school are guarded with privacy,
        and is not available to anyone without parental written permission.

   Montessori School of Salt Lake Inc. - Rules and Regulations

1. Registration Fee - One time annual payment of $35.00 is NOT applicable towards Tuition,
      is non-refundable.
  2. Materials and Supply Fee - One time annual payment of $45.00 is non-refundable.
3. Tuition must be paid in ADVANCE by the FIRST DAY of each month.
  4. A Late Fee of $25.00 will be levied for Tuition Fees paid after the due date.
  5. Every child must be delivered and picked up within the school. (State Regulations)

      Please sign and log your child In/Out each day.

6. A Child's absence from the school must be NOTIFIED promptly at the beginning of the day.
7. Tuition is not deductible for days a child is absent from school,
      with the exception of one week during the summer season.
  8. Termination of contract, a minimum of 30 days notice required, and must be
      pre-approved by the Management.
  9. Children must be picked up from the school no later than 6pm each day.
10. Care provided after 6pm has to be appropriately compensated to the provider
      in attendance at $1.00/minute.

            I agree to abide by the rules set out by the Montessori School of Salt Lake Inc.
                      in accepting Pre-School/Day Care for my child.

Sign____________________________ Date _________

Note: Please fill out a Copy of this Form Completely - obtained at the school.

Child's Name _____________________________________________ (Last, First Names)

Boy / Girl (please circle) Date of Birth _______ / _______/ _______ (mm,dd,yy)

Start Date _______/_______ /________ (mm,dd,yy)

Attendance Hours - ( am, pm, All Day )   (please circle)

   School Attendance -    Mon - Tues - Wed - Thu - Fri    (please circle)

. Parent Name _____________________________________________

Home Address ___________________________________________

   City __________________________ Zip ___________

   Home Phone __________________________________

   Work Phone __________________________________

Emergency Contact Name _______________________________________________

Relationship ____________________________________________________________

Emergency Contact Phone ________-______-___________

Please Add Any Comments _________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

Submitting Current Immunization Records, please circle YES.
(Otherwise circle NO, state reason below and forward an authorized explanation for our records.)

________________________________________________________________________________

Note: Please fill out a Copy of this Form Completely - obtained at the school.

Montessori School of Salt Lake Inc. 2806 East 3300 South Salt Lake City, Utah 84109 montessori-sosl.com / msosl.org

Montessori School of Salt Lake Inc.
2806 East 3300 South
Salt Lake City, Utah 84109 montessori-sosl.com / msosl.org