Child's Information

Child's Full Name*

First name child prefers (for example: a nickname)

Pronouns (for example: she/her, he/they, he, they)*

Child's birthdate*

When would your child be starting at Puddletown?*
2023-242024-252025-262026-27

What program(s) and schedule would you like for your child? Check all that apply:*
Preschool/Kindergarten 8:20am-1:00pm (half day, 3-6 year olds, 5 days/week)Preschool/Kindergarten 8:20am-3:00pm (extended day, 3-6 year olds, 5 days/week)Elementary/1-6th Grade 8:20am-3:10pm (6-12 year olds, 5 days/week)Middle School/7-8th grade 8:45-3:30pm (12-15 year olds, 5 days/week)Before Care 7:30am - 8:20am (all ages, offered 5 days a week)After Care 3:20pm - 5:30pm (all ages, offered 5 days a week)

Has the child attended another school or program? If yes, please give the name of school/program

Does your child have siblings? Please give name(s), pronouns, and age(s).

Please read this Statement of Inclusivity and Anti-Bias Anti-Racist Education

Puddletown strives to become a school where all children and families are welcome, feel welcome, and see themselves reflected here. Puddletown works quite intentionally to nourish a child’s development of identity, their relationship to their community, their process for conflict resolution with community members, and the community’s collective pursuit of peace. Montessori education is ultimately education for peace, as such, we also aim to foster and cultivate an understanding of justice and confidence to stand up in the face of injustice, as without justice there can be no peace.

Puddletown School is actively becoming an anti-biased and anti-racist place to learn, work and grow. To be effective, anti-bias and anti-racist education works as an underpinning perspective, which permeates everything that happens in an educational setting. Puddletown’s staff incorporates the following tenets in our classrooms and spaces, and we ask that families agree to these tenets being upheld. These were developed by Louise Derman-Sparks and Julie Olsen Edwards, co-founders of the National Education Association for Young Children:

1. Staff will nurture each child’s construction of knowledgeable, confident, individual personal and social identities.

2. Staff will promote each child’s comfortable, empathetic interaction with people from diverse backgrounds.

3. Staff will foster each child’s capacity to critically identify bias and will nurture each child’s empathy for the hurt bias causes.

4. Staff will cultivate each child’s ability and confidence to stand up for oneself and for others in the face of bias.

Puddletown School invites any child whose family is interested in Montessori education to apply for entrance to our Montessori program, no matter a family’s financial situation. We are always open to discuss resource access and to connect any family to scholarship funds as we can.

Every year Puddletown School attempts to achieve a balance of age, identified gender, and Montessori experience within our classrooms. Puddletown School does not discriminate on the basis of race, color, national or ethnic origin in hiring, promoting, or training of employees, nor in the admissions, rights, privileges, programs and activities of its learners.

Generally, Puddletown is not equipped outright nor licensed to care for children with disabilities requiring specialized equipment or one-on-one aides; therefore any such care is conditional upon the family and staff properly arranging for the child’s needs to be met. It is the goal for each child to be able to participate in and substantially benefit from this Montessori program without risk to themselves or other children. Puddletown School reserves the right to limit entrance to the program or ask that a child be unenrolled from the program after a trial period, based on whether or not we have or can successfully access and implement the tools and strategies to best support a child's needs, or whether we’ve been able to successfully collaborate with a family and/or a child’s outside support professionals to get the child’s needs met.

Family/Caregiver Information

Who are the people closest to your child? (After this "Important Adults" section, a separate section will then follow for additional Emergency Contacts and Pick Up Authorizations.)

Health and Safety Information

Child's Primary Care Physician*

Physician's Phone Number*

Insurance Information*

Please list any specific allergies or intolerance to food, medication, etc. and action to take in an emergency:

Is your child Deaf or hard of hearing, Blind or visually-impaired, living with a disability, neurodiverse, or has special needs? If so, please briefly share some initial information. What would be important for us to know as we welcome and support your child?

Emergency contacts

Please list details for a total of two additional emergency contacts we Puddletown can reach out to if "Important Adult(s)" are not available?

Any additional adults authorized to pick up your child, other than those indicated in Important Adult section and Emergency Contacts? Please list any additional names, relationship to child, what child calls them, their phone number, and whether you want them to be able to pick up anytime or only with advance notice.

Thank you for taking the time to complete this application. We look forward to being in touch with you!