Preschool Student Questionnaire

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Preschool Student Questionnaire

Preschool Student Questionnaire

  • MM slash DD slash YYYY

  • Emergency Contact

    (other than parents)

  • Other people that may pick up my child from school

    (If they are not on this list, your child will not be able to go with them.)

  • Members Of Household

  • Disclaimer/Liability Waiver

  • Please read carefully and sign agreement below:
    • I understand fully that even after responsible precautions have been taken, class activities may involve hazards for which Duvall Performing Arts (DPA), Preschool program, cannot be held responsible. In the event that my child or I become sick or injured during class, I authorize DPA staff to seek appropriate emergency care. In signing below, I certify that my child and I are covered by health insurance or Medicaid. In the event of an emergency, I will provide DPA with my Insurance Provider and Policy number.
    • I have read, understand, and agree to comply fully with DPA enrollment/registration policies regarding tuition payments and late fees. CLASSES RUN FROM Sept 13th - June 9th. Registration fees ($35) are collected at enrollment, Curriculum fee is collected with 1st month's tuition ($100 for 3’s, $135 for PreK) on August 31st. A $20 late fee will be applied to any tuition paid after the 15th of the month.
    • I release DPA and is instructors, staff, and directors form and any and all liability of any kind and nature whatsoever which may arise out of, or in connection with, the registrant’s participation in the programs offered or use of services or facilities or the premises where DPA is located. This assumption of risk and release is binding upon registrant and registrant heirs, executors, administrators, assigns, and family members.
    • I understand that DPA HAS THE RIGHT TO CHANGE SCHEDULES, INSTRUCTORS, POLICIES, AND/OR RATES at any time. DPA will make every effort to communicate changes in advance, however, it is MY responsibility to read emails from DPA and come to DPA’s front desk or call to stay current on all charges due, class information, holiday/break schedule, weather closures, showcase details, and special events.
    • Refund Policy: I understand that I am to give a months’ notice before withdrawing my child. If I pay a month’s tuition and decide to withdraw my child, I will not be reimbursed for missed days. I understand that all withdrawal requests must be made in writing to the preschool. Duvall Performing Arts Preschool, PO Box 693, Duvall WA 98019.
  • This field is for validation purposes and should be left unchanged.