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STUDENT AND GUARDIAN INFORMATION

Child's Legal First & Last Name(Required)

Date of Birth(Required)

Preferred Name

Start Date(Required)

Gender(Required)

Male

Female

Height(Required)

Weight(Required)

Eye Color(Required)

Hair Color(Required)

Primary Language(Required)

Role(Required)

Parent

Guardian #1

Name(Required)

First Last

Address(Required)

Street Address City State ZIP Code

Email(Required)

Cell Phone(Required)

Work Phone(Required)

Employer Name(Required)

Employer Address(Required)

Street Address City State ZIP Code

Role

Parent

Guardian #2

Name

First Last

Address

Street Address City State ZIP Code

Cell Phone

Work Phone

Employer Name

Employer Address

Street Address City State ZIP Code

EMERGENCY CONTACT & RELEASE INFORMATION

These emergency Contact people can make decisions about your child's care in an emergency when parents cannot be reached. Please list contacts other than parents/legal guardians in order to be contacted. Persons authorized to pick up your child must be 16 years or older. At least TWO of these contacts are REQUIRED to have permission for us to release your child into their care. These contacts should be able to pick up a child in case of an emergency within an hour of contact. Please check "YES" next to the emergency contact designates if both parents/guardians cannot be reached. This information is only valid for one year from date form is signed by parent/ guardian. NOTICE: You are financially responsible for any late pick-up fees incurred by the people fisted below, and that we will not release your child to anyone who is not on the list without verifiable written instructions from the child's legal guardian. Upon a child's pick-up, picture identification will be required for verification.

Parent Designated as Primary Contact During School Day(Required)

Contact 1 Name (Different from Parent)(Required)

First Last

Address(Required)

Street Address City State ZIP Code

Cell Phone(Required)

Work Phone(Required)

Relationship to Child(Required)

Authorized for Pickup?(Required)

Yes

Authorized Emergency Contact?(Required)

Yes

Contact 2 Name (Different from Parent)(Required)

First Last

Address(Required)

Street Address City State ZIP Code

Cell Phone(Required)

Work Phone(Required)

Relationship to Child(Required)

Authorized for Pickup?(Required)

Yes

Authorized Emergency Contact?(Required)

Yes

Please record if there is an existing restraining order or custody arrangement we should be aware of. We will need you to provide copies of of official documents, which you will be able to attach at the end of this form.

“Our experience with Country Montessori has been phenomenal!”

“We are very pleased with the values of respect and kindness all of the teachers help instill in our daughter whether in beforecare, the classroom during the school day, or aftercare. They foster and support creating a wonderful sense of curiosity and learning. Every day she is excited to share something new with us. We cannot be happier with our choice of having her attend Country Montessori.”

Rob and Jill Smith-Lakow

“My husband and I are grateful for all CM has done for our family.”

“We sent both of our children to Montessori from the age of 2.9 until their last year of pre-k. My kids grew so much from their time at Montessori. The teachers and Laura are all amazing. They take their time with each child and recognize their strengths and weaknesses. I’m so happy for the friendships and social skills my kids have learned and their immense developmental skills they gained!!”

Lindsay Donohoe

“My kids are learning more than I could have imagined at their ages.”

“The school, teachers and director are fantastic! Everyone is very attentive to the children and the Montessori curriculum allows the kids to explore and grow at their own pace. The school has gone above and beyond to communicate clearly everything from overall policies to daily updates. We see pictures of the kids through the day on an interactive app and get updates and direct communication from the teachers as well.”

“I’m impressed with the quality of education and care my son receives.”

“Since starting at this preschool, my son has become more confident, independent, and curious. He loves going to school and has formed close bonds with his teachers and classmates. I appreciate the emphasis on respect for others and the environment, which is evident in everything from the way the classrooms are set up to the activities the children engage in. I'm consistently impressed.”

B. Thom Stevenson

“Everyday Jonah was greeted with smiles, open arms, and hearts!”

“Jonah joined Country Montessori as his first preschool experience as a very shy and scared 3 year old. We were so worried as to how he would adjust and to how the school would feel about him. Not only did he absolutely thrive, his speech and social skills all improved tremendously throughout the year. He has learned in leaps and bounds and we couldn’t be any happier to have him be a part of Montessori for next year!”

Jason and Judy Stein

Enrollment Form

STUDENT AND GUARDIAN INFORMATION

EMERGENCY CONTACT & RELEASE INFORMATION

REGISTRATION AND FINANCIAL

PERMISSIONS

DEVELOPMENTAL HISTORY FORM

General Development Information

Toilet Habits

Sleeping Habits

Social Relationships

Daily Schedule

THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF EARLY EDUCATION AND CARE

LET'S GET TO KNOW YOU

We look forward to helping shape your child's future!

“Our experience with Country Montessori has been phenomenal!”

“My husband and I are grateful for all CM has done for our family.”

“My kids are learning more than I could have imagined at their ages.”

“I’m impressed with the quality of education and care my son receives.”

“Everyday Jonah was greeted with smiles, open arms, and hearts!”

“Our experience with Country Montessori has been phenomenal!”

“My husband and I are grateful for all CM has done for our family.”

“My kids are learning more than I could have imagined at their ages.”

“I’m impressed with the quality of education and care my son receives.”

“Everyday Jonah was greeted with smiles, open arms, and hearts!”

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