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AXIS Preschool Family Programs Form

Please complete the form below. Required fields marked with an asterisk *


Student's Gender:*
Answer Required
Is this student Hispanic / Latino?*
Answer Required
Which of the following groups best describes the student's race? (Check all that apply)*
Answer Required
Partner Language:*
Answer Required
Student lives with:*
Answer Required
Do you anticipate using Before and/or After Care and/or School's Out Day services?*
Answer Required
Do you anticipate needing financial assistance for these services?
Answer Required

Receipt of Family Programs Policies and Procedures:

Please review the AXIS Family Programs Policies and Procedures then sign below.

By typing your name below, you attest you are the parent/guardian of the student listed, and you have read and understand the AXIS Family Programs Policies, commit to the rules and regulations therein. If you have any questions please refer to the Family Programs Manager at [email protected].

Authorization for Pick-Up Person(s):

I understand that any person(s) listed on the Infinite Campus Online Enrollment form as an emergency contact will e authorized to pick-up my child at anytime with NO additional written and/or verbal authorization. I also understand that it is my responsibility to make any and all changes as they arise through my Infinite Campus Parent Portal.

I understand and agree to the statement above.*
Answer Required

Screen Time and Media Usage in Classrooms:

As a State of Colorado licensed center, we abie by all state licensing rules and regulations. Below are the adhered to regulations regarding screen time and media usage:

  • All television, recorded media, computer, tablet and media devices are prohibited during snack or meal times.
  • All media that children are exposed to must not contain explicit lanuage or topics
  • Screen time is strictly used to support learning in partner language or English

Regulations for facilities caring for children require that media use is permitted only with the written approval of a student's parent or guardian. These activities must not contain violence, profanity, nudity, sexual, or inappropriate content. All students must be provided with an alternative activity once the student(s) lose interest in the media activity.

Video viewing:*
Answer Required
Computer and/or Tablet Use:*
Answer Required

Photo Release:

I understand my student may be photographed at AXIS during normal hours, on Preschool / K - 5th field trips, or during Preschool / K - 5th activities. I understand that these photographs may be used in promoting AXIS school / child care services, either in print or on the internet. 

To opt-out of photo release for my student, I must follow the guidelines outlined in the AXIS Family and Student Handbook

Topical Application Administration:

I understand topical applications such as lip balms, lotions, diaper cream, ointment, etc. can only be applied as preventative measure. It is required by licensing that application to open or oozing sores requires a medication administration form signed by a parent / guardian and the student's physician. Provided topical application must:

  • Be appropriate for the use of the child
  • Applied according to the instructions on the label
  • Labeled with the child's full name
  • Handed to a staff member, not left in a backpack or cubby
  • Be within the expiration date
  • Aerosol sprays of any kind will not be used
I give permission for qualified AXIS staff to apply / administer appropriate topical medication to my student: *
Answer Required

Sunscreen and Insect Repellent Administration:

Prior to being applied by the center, sunscreen and insect repellant should be applied should be applied at least once at home to test for allergic reactions. All sunscreen and insect repellents provided by the parent or guardian must:

  • Sunscreen must be at least SPF 15.
  • Insect repellant may only be used if recommended by public health officials or requested by parent or guardian.
  • Repellant may contain no more than 30% DEET.
  • Remain in it's original containter
  • Labeled with the student's first and last name
  • Be within the expiration date
  • Nut and gluten free
I give permission for qualified AXIS staff to apply sunscreen and/or insect repellant, provided by me or a physician, to my student.*
Answer Required

Cot or Mat Release:

On behalf of myself, my family, my minor child, I hereby release and agree to defend, hold harmless, and indemnify AXIS International Academy, it's subsidaries, affliates, and employees from all and any claims of injury or damage (including personal injury) resulting there from my decision to allow my child to begin sleeping on a cot or mat while at the center.

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