• Mother (or legal guardian)

  • Father (or legal guardian)

  • Emergency Contact

    In case of an emergency and the PARENTS cannot be reached, please contact the following:


  • Authorized Pick Up

    The following people are authorized to pick up and drop off the above child:
    I hereby give my consent to have my child treated by a physician for medical or surgical care should an emergency arise. I understand that every effort will be made to contact me or a relative before such action is taken. I have been advised that Grace Community School provides liability insurance for my child. My child may take approved field trips sponsored by the child care facility. I hereby give my consent to have my child photographed and/or videotaped and his/her picture placed on display at the childcare facility, reproduced and printed in our student yearbook, and/or displayed on the school’s website. I agree to pay the amount due in advance, on a weekly or monthly basis, for the time my child is enrolled. I understand that I may withdraw at any time by notifying the school two full weeks in advance. Withdrawal is effective the following Friday of the week of notification, and all fees are payable upon other absences. I have received and read the policies of Grace Community School, and agree to abide by the regulations set forth in them; including the obligation to confer with the school first if I have any questions or problems.
  • This field is for validation purposes and should be left unchanged.