HPNS Application & Deposit forms
Health Entrance Requirements
(In accordance with the requirements of the Department of Social Welfare)
Parent or legal guardian must present a form signed by a physician stating that each participating child is fit to take part in preschool activities. (Physician’s Report - LIC 701)
Parent or legal guardian must fill out and sign the Child’s Pre-admission Health History (LIC - 702) for each participating child.
Parent or legal guardian must fill out and sign the Consent For Emergency Medical Treatment (LIC - 627) for each participating child
Children must have been inoculated as outlined by the State of California guidelines. (Include a copy of immunization records)
Emergency information must be on file at the school for each participating child. (Identification & Emergency Information - LIC 700)
A signed exemption form for religious reasons is acceptable for the above if approved by the Executive Board.
Parent or legal guardian must fill out and sign the Child’s Pre-admission Health History (LIC - 702) for each participating child.
Parent or legal guardian must fill out and sign the Consent For Emergency Medical Treatment (LIC - 627) for each participating child
Children must have been inoculated as outlined by the State of California guidelines. (Include a copy of immunization records)
Emergency information must be on file at the school for each participating child. (Identification & Emergency Information - LIC 700)
A signed exemption form for religious reasons is acceptable for the above if approved by the Executive Board.
An Emergency Kit is required before starting school
Emergency Kits for each child attending HPNS in your family should include the following:
Once all items are collected and placed in the storage bag provided by HPNS, return Emergency Kit(s) to the teacher by the first day of class.
- Family Photo
- comfort item- for example, a toy
- individual size kleenex
- individual size Wet-Ones
- 2 juice boxes or bottles of water
- nonperishable food items- something healthy
- small flashlight with extra batteries
- a change of clothes, including socks
- a list of contact phone numbers; home, work, grandparents, cell phones, etc.
- any vital information about your child.
Once all items are collected and placed in the storage bag provided by HPNS, return Emergency Kit(s) to the teacher by the first day of class.