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Enrollment Form

Child's Information:

Parent/Guardian Information

1st Parent/Guardian

2nd Parent/Guardian

Authorized Contacts

Please provide AT LEAST TWO authorized contacts with different phone numbers and addresses, in addition to the parent contact numbers.  Authorized contacts and the local authorities can be contacted when parents are not available.

Name of Person to call in case of an emergency if parent/guardian cannot be reached:

First Emergency Contact

Second Emergency Contact

Additional Authorized pick-up persons:

1st Pick-Up Person

2nd Pick-Up Person

3rd Pick-Up Person

Medical Authorization

In the event that I cannot be reached to make arrangements for emergency medical attention, I authorize the director to take my child to the nearest emergency clinic, call the doctor listed below, and/or call for an ambulance.

Parent Permissions

I hereby authorize Mariachi Infantil to allow my child to leave ONLY with the above persons.
In the event of an emergency (such as a chemical spill, gas leak, or other extreme emergency), Mariachi Infantil has permission to transport my child to a “safer” location.
I hereby authorize Mariachi Infantil to allow my child to be transported in case of medical emergency.
My child has permission to be released to the care of his/her sibling(s) under 18 years old.


I hereby give permission to have my child appear in any media coverage approved by Mariachi Infantil, such as photos for activities, promotion, newsletters, etc.

Financial Responsibility

  • Tuition Payments are to be made by the second class meeting, unless other arrangements have been made with the director (a separate form must be filled out outlining said arrangement).
  • I understand that if I get behind on my payments, it can cause my child to be dropped from the program.  Reinstatement will be granted once my outstanding balance is brought up to date.