Section 1: Student Info

Student Full Name *

Date of birth *

Desired Start Date *

Program Applying For *

Infant
Pre-Primary
Primary
Elementary
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Has your child attended school before? *

Yes

If yes, name of school + dates

Section 2: Parent/Guardian Info

Parent/Guardian 1:

Parent/Guardian 1 Full Name *

Parent/Guardian 1 Relationship to Child *

Parent/Guardian 1 Email *

Parent/Guardian 1 Mobile Phone *

Parent/Guardian 1 Work Phone

Parent/Guardian 1 Address *

Parent/Guardian 2:

Parent/Guardian 2 Full Name

Parent/Guardian 2 Relationship to Child

Parent/Guardian 2 Email

Parent/Guardian 2 Mobile Phone

Option 1
Option 2
Option 3
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Section 3: Emergency + Medical Info

Emergency Contact Full Name *

Emergency Contact Relationship to Child *

Option 1
Option 2
Option 3
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Emergency Contact Phone Number *

Option 1
Option 2
Option 3
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Authorized Pick-Up List (Names + Relationships) *

Doctor’s Name + Phone *

Does your child have any allergies or dietary restrictions? (Yes/No) *

Yes

If yes, please describe (allergies/dietary restrictions)

Does your child have any ongoing medical conditions, take any medications, or have any diagnoses? *

Yes

If yes, please describe (medical conditions)

Section 4: Permissions

Do you give Hill Point Montessori permission to use photos or videos of your child on our website and/or social media for school-related purposes (such as sharing Montessori learning moments, celebrating classroom life, or promoting the school)? *

Yes

Do you give Hill Point Montessori permission to administer basic first aid to your child if needed (e.g., ice packs, Band-Aids, minor wound cleaning)? *

Yes

Section 5: Acknowledgment + Signature

Parent/Guardian Name (as signature) *

Date *

I certify that the information provided is accurate to the best of my knowledge. *

Yes

I agree to this privacy policy. By providing my phone number, I agree to receive text messages from Hill Point Montessori Preparatory School.