Oxford Community Preschool Enrollment
2024-2025 School Year
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Child's First & Last Name *
Birthdate *
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DD
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Child's Gender: *
Child's Complete Address (Street, City, State, Zip Code) *
Which class do you prefer? We will make every effort to give you your 1st choice. *
Parent/Guardian #1 First & Last Name *
Parent/Guardian #1 Complete Address if different than above
Parent/Guardian #1 Phone Number *
Parent/Guardian #1 Email Address *
Parent/Guardian #1 Employer *
Parent/Guardian #2 First & Last Name *
Parent/Guardian #2 Complete Address if different than above
Parent/Guardian #2 Phone Number *
Parent/Guardian #2 Email Address *
Parent/Guardian #2 Employer *
Child resides with: *
School District child resides in  *
Emergency Contact #1 (other than parents/guardians) Name & Phone Number *
Emergency Contact #2 (other than parents/guardians) Name & Phone Number *
Please list sibling names and ages/grades: *
Child's Doctor - Name & Phone Number *
Child's Dentist - Name & Phone Number *
Does your child have any food allergies? If yes, please list which and the reaction: *
Does your child have any allergies to medication? If yes, please list which and the reaction: *
Does your child have an Individualized Education Program (IEP)? *
Does your child currently receive services for (check all that apply): *
Required
Is your child fully potty trained (child has the awareness to use the bathroom, is able to manage his/her clothes with little or no assistance, and has the ability to clean him/herself appropriately with little to no assistance)? 
*Children in Juniors classes (ages 3-4) and Pre-K classes (ages 4-5) must be fully potty trained.
 *
Is your child current with all immunizations *
If no, list the reason for not providing immunization records (Oxford Community Preschool reserves the right to deny admittance of a child that is not immunized if he/she is deemed a health risk to other children or staff members and/or if immunization records are not provided):
If a Parent/Guardian or Emergency Contact cannot be notified and immediate emergency care is necessary, by signing below you agree that your child may be transported to the nearest medical facility deemed appropriate by emergency care workers and give permission for the medical facility to provide emergency treatment as deemed necessary by emergency care workers. By signing below (full name & date), you further assume responsibility for any fees incurred for such an emergency: *
The Director, or appointed OCP staff member, compiles a confidential list of students that have significant health/medical concerns each school year. This list is shared for the sole purpose of protecting the health and well-being of all students. By signing below (full name & date), you agree to share any appropriate health information with our OCP staff: *
Please list any additional information we should know about your child:
Pennsylvania State and Local Law Enforcement require all children under the age of four (4) be properly restrained in an approved car safety seat. The law also dictates that children aged four (4) to eight (8) years old be restrained in an approved booster seat. Children must meet the required manufacturer's specifications along with Federal and State Safety Standard for height and weight limits.

In adherence to these laws, Oxford Community Preschool WILL NOT release any child
into a vehicle in which the child safety seat(s) do not meet or exceed Federal, State, and Local Safety Guidelines through our car line. Further, OCP will ask that parents/guardians park and utilize our walk up line if an approved child restraint or booster seat is not being used in your vehicle. Staff will follow the guidance of NHTSA.gov, PAkidstravelsafe.org, safekids.org and the Insurance Institute for Highway Safety’s recommended best practice of placing children in the back seat ONLY. In addition, no child will be released into car line without a signed Car Seat/Booster Seat Policy on file for EACH student.

Oxford Community Preschool and Oxford Presbyterian Church will not be held liable for any child’s car seat/booster seat that is not properly installed. 
By signing this agreement (typing full name and date), you will not hold any staff member or volunteer of Oxford Community Preschool or Oxford Presbyterian Church liable for any incidents (injuries up to and/or including dismemberment and/or fatality) that may occur after assisting your child into their car seat or booster.
*We have a certified Child Passenger Safety Technician on staff who is more than happy to answer any questions, check your car seat, or offer assistance in any way.
 *
I grant permission for Oxford Community Preschool and Oxford Presbyterian Church to use photos and videos of my child named above for (check all that apply):
 *
Required
I grant permission for Oxford Community Preschool to include my child's name, address, and birthdate as well as the names, cell phone numbers, and email addresses of his/her parents/guardians in the class directory that will be distributed to all families in my child's individual class at the start of the school year.
 *
Would you like a form for Tuition Express (our online automated tuition payment option)? *
Teacher Requests and/or Special Requests:

OCP will attempt to accommodate parent/guardian special requests if possible. 
 
By signing below (full name & date) you acknowledge that all information included on this form is accurate to the best of your knowledge and that you agree to the aforementioned policies/procedures: *
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