Cross of Life Montessori School
Programs
Toddler Program (15 - 36 months)
Primary Class (3 - 6 years)
Catechesis of The Good Shepherd
The Children's Garden
About Us
Director's Letter
COL Church
Mission Statement
FAQ'S
Staff
Montessori
Montessori Overview
Dr. Maria Montessori
Montessori Library
The Montessori Advantage
Admission
Virtual Tour
Enrollment Steps
Online Student Application
Tuition
Parent's Corner
Covid-19 Procedures
Parent Association
>
PA Meetings and Teacher Appreciation Lunches
Pizza Days
Calendar
Events
>
February Parent Ed - Importance of the 3rd year
Forms
>
Transportation Permission
Lunch Hour (12pm-1pm)
Student Directory
Staff Directory
Quick Reference Page
Birthdays in the Primary Class
Class Supply Lists
>
Toddler Snack Shopping List
Toddler Class Supply List
Toddler Snack Schedule
Primary Class Supply List
Primary Snack Shopping List
Primary Snack Schedule
Giving
Apogee Scholarship
Volunteer Opportunities
Indirect Fundraising Opportunities
Blog
Contact
MEDICAL RELEASE & ALLERGY INFORMATION FORM
Medical Information Form
*
Indicates required field
Child's Name
*
First
Last
Date of birth MM/DD/YYYY
*
Allergy Information
*
My child has no known allergies
My child has allergies which are detailed below
Allergies and Reactions
*
I understand that anaphylactic or severe reactions requiring medication must complete the 'Emergency Action Plan' on file in the office
*
Yes
Other medical alerts
*
Prescriptions taken on a daily basis
*
Pediatrician's Name
*
Address
*
Phone Number
*
Preferred Hospital
*
Special Instructions
*
Primary Insurance
*
Policy/Group Number
*
Health History
Hospitalized
*
Yes
No
Reason
*
Chronic Illness
*
Ear Infections/Tubes
*
Speech Delay or Impairment
*
Other information that would be helpful for caregivers
*
Medical Release
To Whom it May Concern:
I hereby authorize the bearer, who is a staff member at Cross of Life Montessori School, to sign any forms required to admit my child for emergency treatment at the nearest facility. I do so in order to ensure that my child may recieve prompt medical attention in case of emergency when I cannot reach the facility promptly.
I certify that I will be held liable for all medical and hospital expenses incurred in this regard.
I certify that all the information on the Medical Form is true and complete.
Electronic Signature
*
By checking yes, I authorize my signature typed above
*
Yes
No
Today's Date MM/DD/YYYY
*
Submit
Programs
Toddler Program (15 - 36 months)
Primary Class (3 - 6 years)
Catechesis of The Good Shepherd
The Children's Garden
About Us
Director's Letter
COL Church
Mission Statement
FAQ'S
Staff
Montessori
Montessori Overview
Dr. Maria Montessori
Montessori Library
The Montessori Advantage
Admission
Virtual Tour
Enrollment Steps
Online Student Application
Tuition
Parent's Corner
Covid-19 Procedures
Parent Association
>
PA Meetings and Teacher Appreciation Lunches
Pizza Days
Calendar
Events
>
February Parent Ed - Importance of the 3rd year
Forms
>
Transportation Permission
Lunch Hour (12pm-1pm)
Student Directory
Staff Directory
Quick Reference Page
Birthdays in the Primary Class
Class Supply Lists
>
Toddler Snack Shopping List
Toddler Class Supply List
Toddler Snack Schedule
Primary Class Supply List
Primary Snack Shopping List
Primary Snack Schedule
Giving
Apogee Scholarship
Volunteer Opportunities
Indirect Fundraising Opportunities
Blog
Contact