Student Registration

Welcome to Bella Mente. We are excited to have you part of our community! We have a three step electronic registration process outlined below. Please review each step and be sure to fill out the links for EACH child you are registering.

Review our parent handbook and parent enrollment information packets linked below
Parent Handbook
Parent Enrollment Information
Please fill out the registration form below for EACH child you are registering for Bella Mente Early Learning. This includes students in our School Age Program.
Please email us a copy of your child's most recent vaccinations. You can easily find this on mychart. Please send them to bellamenteearlylearning@gmail.com with the subject line as follows: Your child’s name, “vaccination record”, the date. You can use the forms below for reference to the vaccinations needed.

Child's Full Name

Child's Birthday

Parent/Guardian Name

Parent/Guardian Phone Number

Parent/Guardian Email

Parent/Guardian Name

Parent/Guardian Phone Number

Parent/Guardian Email

Physical Address

Mailing address

if different than physical address

Other Contacts

Other than you who has permission to pick up your child, please include names and phone numbers

Emergency Release

In case of emergency, I give permission for any of the above individuals to be contacted and my child may be released to any of them.

I Agree: I give permission for any of the above individuals to be contacted and my child may be released into their care

Allergies

Please describe any allergies or health concerns you have for your child.

Health Problems or Concerns?

Current Medications

Date of Last Physical Exam

Child's Healthcare Provider

Insurance Company Name

Policy Holder's Name

Policy Number

Medical Consent: By checking the "I agree" box below and typing my full name and date, I recognize this as my electronic signature verifying that I give permission that my child, listed above, may be given first aid/emergency treatment by a child care licensee and/or qualifies staff at: Bella Mente Early Learning

I agree

Medical Consent: When I cannot be contacted, I authorize and consent to medical, surgical and hospital care, treatment and procedures to be performed for my child by a licensed physician, healthcare provider, hospital or aid car care attendant when deemed necessary or advisable by the physician or aid car attendant to safeguard my child’s health. I waive my right of informed consent to such treatment. I also give permission for my child to be transported by ambulance or aid car to an emergency center for treatment. I certify under penalty of perjury under the laws of the State of Washington that this information is true and correct. By checking the "I agree" box below and typing my full name and date, I recognize this as my electronic signature

I agree

Sunscreen

During summer months, I will apply sunscreen to my child before coming to school and allow Bella Mente to apply as needed with a personal or bulk sunscreen provided from home or Bella Mente.

Photo/ Video Release

Photos and videos provide an incredible insight to our learning process here at Bella Mente. We use this as a way to document your child’s creative process. It serves as a way for teachers to showcase how children got to where they are, it becomes a way for children to revisit their understandings and it provides a window into their day for the parents. In selecting "I agree" below, I grant Bella Mente Early Learning the right to take photographs of my child. I agree that Bella Mente Early Learning may use such photos for any lawful purpose including, for example, classroom documentation, classroom Facebook pages, portfolios, learning resources in the classroom, teacher training, website content or advertising.

Walking Field Trips

In selecting" I agree" below, I grant Bella Mente Early Learning staff the right to take my child on walking field trips from Bella Mente during normal business hours. Walking Field trips will: ● Never exceed 2 hours ● Be age appropriate for each of our classes ● A note will be placed on the door when the class leaves ● Staff will have First Aid Kits and phones for emergencies This includes but is not limited to: ● The Garden lot next to our playground (We plan to use this Daily) ● Art Studio ● The walk between classrooms and the playgrounds ● Trash runs to the basement (may use elevator) ● Walks around the neighborhood

School Age Transportation

**THIS IS FOR SCHOOL AGERS ONLY** I grant Bella Mente Early Learning the right to transport my SCHOOL AGE child via van, personal car, or with a contracted transport service during normal business hours. This includes transportation from an approved School during Seattle public schools calendar year, and for any field trip during the child’s enrollment at Bella Mente Early Learning.

Parent/Guardian Signature: By checking the "I agree" box below and typing my full name and date, I recognize this as my electronic signature verifying that I have read and understand the information provided in the handbook and enrollment packets and that the above information is up to date and accurate.

I agree