Worldmind Application for Admission
Thank you for applying for your child to attend Worldmind School for the 2021-2022 school year! Please take the time to fill out this admission application as we transition to a new and improved online system for school enrollment.

** Your application will not be accepted or finalized until a $75 application fee is paid. A QuickBooks invoice link will be sent to your email after submitting this form. **

If you have any questions, please call 970-640-9033 or email worldmind@worldmindnatureschool.com. Thank you!
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Email *
First and Last Name of Child: *
Grade: *
Today's Date: *
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General Student Information
Parent/Guardian Mailing Names: *
Applicant's Full Address: *
Parent/Guardian Phone: *
Applicant's Sex: *
Applicant's Date of Birth: *
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Age as of September 1: *
Present Grade: *
Currently Enrolled at Worldmind: *
Preschool Schedule Options (FOR P3 & P4 ONLY)
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Family Information
Are the applicant's parents/guardians: *
If applicable, who has legal custody? (Please provide legal document defining custody if not joint custody.)
With whom does the applicant reside? *
Language(s) spoken in the home: *
Parent/Guardian Information
Please fill out one or both parent/guardian information sections, as applicable to your family.
Parent/Guardian Full Name: *
Parent/Guardian Full Address: *
Parent/Guardian Phone: *
Parent/Guardian Email: *
Parent/Guardian Employer: *
Parent/Guardian Occupation: *
Best Way to Reach Parent/Guardian: *
Parent/Guardian Full Name:
Parent/Guardian Full Address:
Parent/Guardian Phone:
Parent/Guardian Email:
Parent/Guardian Employer:
Parent/Guardian Occupation:
Best Way to Reach Parent/Guardian:
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Student's Medical Information
Name and Phone Number of Student's Doctor: *
Hospital of Preference: *
Operations or Serious Injuries (List Dates): *
List All Medications and Explain: *
List All Physical Limits and Explain: *
List All Dietary Limits and Explain: *
Chronic Medical Conditions: *
Does the applicant have a health plan that the school should be made aware of? *
Health History: *
Allergies: *
Describe the allergies above, including the nature of the allergic reaction: *
Emergency Contact Information
Name of Emergency Contact 1: *
Relationship to Student Contact 1: *
Cell Phone for Emergency Contact 1: *
Email for Emergency Contact 1: *
Name of Emergency Contact 2: *
Relationship to Student Contact 2: *
Cell Phone for Emergency Contact 2: *
Email for Emergency Contact 2: *
Release of Liability
The enrolling family understands that participating in physical activities during Worldmind Prep classes,
even with proper supervision, may result in serious injury, illness, or even death. The enrolling family
hereby relinquishes the teacher of this class, all parties working with him/her, the facility hosting classes,
Worldmind Nature Immersion School, the makers and owners of all equipment and props used herein, and
all other participants in these activities, of any liability whatsoever relating to their participation in these
activities, and agrees to inform their instructors of any and all factors which may affect their child’s ability to
participate in these activities, including but not limited to, disabilities, illnesses, or injuries. The enrolling
family understands that they participate in these activities at their own risk.
Release of Liability Signature: *
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