Crystal Springs 2019 Summer Camp Enrollment Form

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Page 1 -- Registration Info --












- Child's Information -






MM/DD/YYYY
















































































- Emergency Contact Information -

*The following information must be filled out to enroll at CSPS and the contacts MUST be within a close distance of the preschool. This is for your child's safe return home should he/she become ill, injured or a disaster occurs while at school.*
In case of an emergency, if unable to reach parents, the following will be contacted:

NOT the child's parent/guardian


NOT the child's parent/guardian





In the event of a major disaster, such as an earthquake, the following nearby neighbor or friend will welcome your child if you or the above emergency contact (or other authorized adults) cannot make it to the school: 

NOT the child's parent/guardian







NOT the child's parent/guardian






- Participating Parent Information -

The "Participating Parent" (formerly known as the Working Parent) information collected in this section of registration is defined as the primary adult that will be staying for one assigned day a week during the preschool class time to work in the activity rooms, outside, during circle and provide snack on a rotating basis. This adult may be the child's mother, father, grandparent, nanny or other designated adult that will follow the policies and guidelines as outlined in the CSPS Handbook and Membership Responsibility Agreement (this agreement will be updated by start of school) and Risk Management Manual.

Please Note: the "Participating Parent" and contact information will be listed on the class roster.















- Permissions -


Internal use of photograph:  I give permission for my child to be photographed/videotaped in scheduled preschool activities. His/her photograph may be used internally -- in the classroom, end of year slideshow, private/closed social media groups and preschool newsletter.

External use of photograph:  I give permission for my child to be photographed/videotaped in scheduled preschool activities.  His/her photograph may by used externally by CSPS and Shoreline Community College promotion including web sites - children will not be named.

NO photographs may be used:  I decline the use of any photographs of my child.  I understand that this means he/she will NOT be included in photos posted in the school hallway/activity rooms, in the end of year slideshow, graduating yearbook, or on private/closed social media groups.


This includes your spouse, child's Non-Participating Parent, and other CSPS families.



Page 2 -- Acknowledgements --


    1. Submit an online Parent Education Application (choose the June Class).

    2. Review, sign and date Membership Responsibility Agreement for Summer Session.

    3. $150 non-refundable registration fee/summer tuition due at time of enrollment --by check or money order only-- must have child's last name and 'summer' noted.

    4. If not enrolled in the 2019-2020 school year: Completed, signed and dated Washington State Certificate of Immunization (must be on this form - doctor's office printout is not accepted. Please be sure to sign it!). Note: If you know your child is on a delayed schedule or is missing certain vaccines, please have his/her medical provider complete and sign a Certification of Exemption.