Parent / Guardian Information
Release to a Non-Parent
To whom may your child be released to other than a parent? Please list their name(s), relationship and phone numbers.
Medical, Allergies & Other Information
Your signature on this form verifies that the information given is correct and that you give permission to the staff of Merry Hearts to provide the necessary care for your child either on site or at the nearest medical facility in the event of a medical emergency. In the even of such an emergency we will make every effort to reach you or your emergency contact.
Thank you for completing the student enrollment form!