Required Forms
Forms Required for All Families Each Year (Returning & New)
Membership Agreement 2009-10 School Year (Google Document)
Identification & Emergency Information (LIC 700)
http://www.dss.cahwnet.gov/cdssweb/entres/forms/English/lic700.pdf
Forms Required for NEW Families Before Attending
California Immunization Record (PDF)
Physician’s Report (LIC 701)
http://www.dss.cahwnet.gov/cdssweb/entres/forms/English/LIC701.pdf
Health Screening Report for Facility Personnel (Worker Parent) (LIC 503)
http://www.dss.cahwnet.gov/cdssweb/entres/forms/English/LIC503.pdf
Child’s Pre-Admission Health History (parents’ report) (LIC 702)
http://www.dss.cahwnet.gov/cdssweb/entres/forms/English/LIC702.pdf
Criminal Record Statement (LIC 508)
http://www.dss.cahwnet.gov/cdssweb/entres/forms/English/LIC508.PDF
Personal Rights (PDF) (LIC 613)
http://www.dss.cahwnet.gov/cdssweb/entres/forms/English/LIC613A.PDF
Notification of Parents’ Rights (LIC 995)
http://www.dss.cahwnet.gov/cdssweb/entres/forms/English/LIC995.PDF
Consent for Emergency Medical Treatment (LIC 627)
http://www.dss.cahwnet.gov/cdssweb/entres/forms/English/LIC627.PDF
Peter Pan Field Trip/Carpooling Consent Form (PDF)
Proof of Auto Insurance & Valid Driver’s License (PDF)
Consent for Medical Treatment Peter Pan Form (PDF) |
