Enrollment Application.pdf


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anyone but be used solely for Roots & Wings and its
website.
I

, give Roots & Wings consent for my

child

, to watch videos that relate to

an activity or subject talked about in class.
Parent Name

Parent Signature

Date

Child’s Biography
Child’s Disposition

H

does your child react when you leave him/her? ______________________________________
What is your child’s normal disposition? ________________________________________________
Does your child have any bad habits? _______ If yes, what are they? _________________________
___________________________________________________
Are there any restrictions to play or activities? ______ If yes, what are they? ___________________
_______________________________________________
Any speech, hearing or vision problems? _______ If yes, which one(s)? _______________________
_____________________________________
Is your child prone to any illness (such as headaches, tummy aches, etc.)? ______ If yes, what are they?
___________________________________________________________________
How is your child most easily settled? ___________________________________________________
Sleeping
child’s mood when they are put to bed? _______________________________________
What is your child’s mood when they wake up? ___________________________________________

W
yo