Preschool Application

SNACS Pre-K Prospective Student Enrollment Application (Step 1)

Sierra Nevada Academy Charter School *Pre-K* Prospective Student Enrollment Application

Step 1 of 4 - Student and Parent/Guardian Information

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SNACS Preschool Interest and Enrollment Application

Student Name(Required)

First Middle Last

Date of Birth

MM slash DD slash YYYY

Birth City/State(Required)

Student Gender(Required)

Academic Year(Required)

Ethnicity(Required)

Check all that apply

American Indian/Alaskan Native

Asian

Hispanic

Black/African American

White/Caucasian

Native Hawaiian/Pacific Islander

Is English your student's home/native language?(Required)

Yes

What was the first language learned or spoken by your child?(Required)

Preferred Language (if not English)

What is the student's home language?

Parent/Guardian Information

First Parent/Guardian Name(Required)

First Last

First Parent/Guardian Email Address(Required)

Enter Email Confirm Email

First Parent/Guardian Relationship to Student(Required)

First Parent/Guardian Phone Number(Required)

Second Parent/Guardian Name

First Last

Second Parent/Guardian Email Address

Enter Email Confirm Email

Second Parent/Guardian Relationship to Student

Second Parent/Guardian Phone Number

Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Mailing Address (if different than Home Address)

Street Address Address Line 2 City State ZIP Code

Preferred contact method(Required)

Student lives with:(Required)

Is there another parent or legal guardian to list?(Required)

Yes

Full legal name(Required)

First Last

Email Address(Required)

Enter Email Confirm Email

Relationship to Student(Required)

Phone Number

Is this person authorized to pick up the child?(Required)

Yes

Is this person authorized to make enrollment and emergency-care decisions?(Required)

Yes

Are there any legal, custody, or court orders that affect who may contact, pick up, or make decisions for your child?(Required)

Yes

Please briefly describe what the school needs to know for safety and release purposes.(Required)

Upload relevant court or custody documentation, if available.(Required)

If the document is not currently available, please contact the preschool office.

Drop files here or

Max. file size: 2 GB.

Emergency contacts and authorized pickup

List at least two additional adults who may be contacted if a parent/guardian cannot be reached.(Required)

For each adult, please provide: 1. Full name 2. Relationship to child 3. Primary phone number

May this person receive information about the child?(Required)

Only adults listed and approved by the parent/guardian may pick up the child, subject to SNACS policy and any applicable court order. Parents/guardians are responsible for keeping this list current.

Yes

Primary health-care provider name

First Last

Provider Phone

Preferred hospital or emergency facility, if the family has one(Required)

Emergency Medical Authorization(Required)

I authorize SNACS Preschool, when I cannot be reached after reasonable efforts, to seek emergency medical or hospital care for my child when immediate care is reasonably necessary. I understand that I remain responsible for costs incurred, subject to applicable law and school policy.

Health, safety and required documents

Does your child have any allergies?(Required)

Yes

Please provide details on allergy, reaction, severity, and emergency instructions(Required)

Does your child have a medical condition, disability, or special health need that may affect participation or care?(Required)

Yes

Explain the need and contact the preschool office for the applicable authorization process(Required)

Has your child had a serious injury, surgery, hospitalization, or recurring health concern that staff should know about(Required)

Yes

Briefly explain(Required)

Are there any communication, mobility, sensory, behavioral, toileting, or developmental supports that would help your child participate successfully?(Required)

Yes

Briefly explain(Required)

Immunization record or approved exemption documentation(Required)

Upload a copy (photo/scan) of your child's immunization records. Immunization records are required before admission unless an applicable exemption or conditional-admission provision applies. If you do not have the record available today, submit the application and contact the preschool office for next steps.

Drop files here or

Max. file size: 2 GB.

Additional documents (e.g., relevant care plan or emergency plan)(Required)

Upload a copy (photo/scan) of your child's care plan.

Drop files here or

Max. file size: 2 GB.

Custody/court documents(Required)

Upload a copy (photo/scan) of your child's custody or court records.

Drop files here or

Max. file size: 2 GB.

Do you have a current physician-completed medical form available?(Required)

Yes

I need help understanding this requirement

Medical Form (Physician completed)(Required)

Upload a copy (photo/scan) of your child's medical form completed by physician.

Drop files here or

Max. file size: 2 GB.

Schedule, financial information, and final acknowledgements

What type of schedule are you seeking?(Required)

Requested start date(Required)

MM slash DD slash YYYY

SNACS Financial Agreement Acknowledgment(Required)

I understand the enrollment fee and deposit requirements.

I understand when tuition payments are due.

I understand the cancellation/withdrawal notice policy.

I understand the policy for absences, holidays, closures, and sick days.

I understand the late-payment policy.

I understand that current tuition rates and policies may be updated according to the enrollment agreement.

I understand and agree to the SNACS Financial Agreement

Required acknowledgments(Required)

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

Required acknowledgments(Required)

I certify that I am the parent or legal guardian, or otherwise authorized to complete this form.

Required acknowledgments(Required)

I understand the illness and exclusion policy.

Required acknowledgments(Required)

I understand the emergency medical authorization.

Required acknowledgments(Required)

I understand the required immunization and medical-form process.

Required acknowledgments(Required)

I understand that I must update contact, health, custody, and authorized-pickup information.

Permissions and Acknowledgements

Preschool Permissions and Acknowledgments

I certify that I am the child’s parent, legal guardian, or other person authorized to complete this form. I certify that the information provided is accurate and complete to the best of my knowledge.

I understand that SNACS may request additional documentation to complete enrollment, verify eligibility for a grant-funded program, comply with applicable licensing or program requirements, and provide safe and appropriate care.

I understand that I may contact SNACS to ask questions, request assistance, or request a translated version of this form.

I agree to the privacy policy.

Photography and Video Permission(Required)

SNACS may take photographs, video recordings, or audio recordings of students during school-related activities. These materials may be used to document learning, support classroom and teacher training, recognize student participation, communicate with families, or share information about SNACS. Please select one option. Your selection will remain in effect until you change it in writing or until the permission period ends, if one is specified by SNACS.

No permission

Internal educational/documentation use only

School communications and yearbook

Public website/social media/promotional use.

May SNACS display or share samples of your child’s work for educational and school-related purposes?(Required)

Yes, I give permission

No, I do not give permission

Required acknowledgments(Required)

I understand that SNACS will not sell my child’s photograph, video, or audio recording as a standalone product. I understand that SNACS may edit or combine approved materials with other school content for the purposes selected above. I understand that I may withdraw this permission in writing; withdrawal will apply to future use and may not be able to remove materials that have already been printed, distributed, posted, or incorporated into completed publications.

May SNACS identify your child by full name when sharing an approved work sample?(Required)

Yes, I give permission

No, I do not give permission

May SNACS share your selected contact information with other currently enrolled SNACS Preschool families for school-community purposes?(Required)

Yes, I give permission

No, I do not give permission

Select the information you permit SNACS to share:(Required)

My name

My email address

My phone number

My mailing address

My child's first name

None of the above

Required acknowledgments(Required)

I understand that this information will not be shared for commercial solicitation or unrelated purposes. SNACS cannot control how another parent may use information after it has been shared. I may withdraw this permission in writing, and future versions of the directory will be updated when reasonably practicable.

May approved educators, college students, practicum students, accreditation reviewers, or other authorized observers observe your child during school-related activities?(Required)

Yes, I give permission

No, I do not give permission

Notice Regarding Access to Student Records(Required)

Notice Regarding Access to Student Records

I understand that SNACS maintains enrollment, attendance, health, developmental, educational, and program records for my child as required by applicable law, licensing rules, grant requirements, and school policy.

I understand that authorized representatives of Nevada child-care licensing, the Nevada Department of Education, Washoe County School District, grant administrators, public health agencies, accreditation organizations, and other governmental or oversight agencies may inspect or receive records when they have legal authority or a legitimate program-related need to do so.

I understand that SNACS will limit access or disclosure to the information reasonably necessary for the authorized purpose and will handle records in accordance with applicable privacy laws, regulations, grant requirements, and school policy.

I understand that this acknowledgment does not authorize SNACS to disclose my child’s records to unrelated individuals or organizations for unrelated purposes.

I have read and understand the Notice Regarding Access to Student Records.

Application Accuracy(Required)

By selecting “Submit,” I confirm that I reviewed the choices above and that my electronic signature applies to the required acknowledgments and permissions I selected.

Parent/Guardian

Please sign to acknowledge agreement to the enrollment contract terms

Today's Date(Required)

MM slash DD slash YYYY

SNACS *Pre-K* Prospective Student Enrollment Application (Step 1)

SNACS Preschool Interest and Enrollment Application

Parent/Guardian Information

Emergency contacts and authorized pickup

Health, safety and required documents

Schedule, financial information, and final acknowledgements

Permissions and Acknowledgements

SNACS Pre-K Prospective Student Enrollment Application (Step 1)