Forms

Welcome to Mountain View Parent Nursery School! We are delighted to have your family join our preschool. In preparation for the upcoming school year, there are many forms that must be completed by a parent/legal guardian. Be assured that all information submitted to MVPNS is handled and maintained in a confidential manner.

Download a zip file with all of the required forms: New Family Forms — Returning Family Forms.

In addition to the forms above, include the adult vaccination and automobile insurance information detailed below.

Please read the information and explanations carefully. Portions of the medical forms listed must be completed by a physician, so please allow adequate time. We suggest you make copies for your files.

Mail all forms to:

Vaccination Records Required (all adult volunteers)

According to California Senate Bill 792, effective September 1, 2016, licensed child care programs are required to maintain vaccination records for influenza, pertussis and measles for their volunteers.

Influenza (one of the following for EACH volunteer)

• (preferred) A signed statement from the volunteer stating they have declined to be vaccinated against the flu.
  The flu vaccine is not available by the start of the school year so we recommend filling out this form (included) and getting the flu shot when it becomes available.
• A copy of an immunization record for influenza dated between August 1 and December 1 of each year
• A statement from the volunteer’s physician that there is a medical reason not to vaccinate the volunteer
• A statement from the volunteer’s physician that the volunteer is already immune to influenza

Pertussis/Whooping Cough (one of the following for EACH volunteer)

• A copy of an immunization record for pertussis
• A statement from the volunteer’s physician that there is a medical reason not to vaccinate the volunteer
• A statement from the volunteer’s physician that the volunteer is already immune to pertussis

Measles (one of the following for EACH volunteer)

• A copy of an immunization record for measles
• A statement from the volunteer’s physician that there is a medical reason not to vaccinate the volunteer
• A statement from the volunteer’s physician that the volunteer is already immune to measles

Automobile License and Liability Information (co-op classes only)

• Photocopy of current driver’s license(s)
• Photocopy of current automobile insurance that includes your name, dates of policy coverage, and automobile Bodily Injury Liability coverage.
  Mountain View Parent Nursery School’s insurance company requires drivers on field trips to carry a policy that provides Bodily Injury Liability coverage of $30,000 per individual and $60,000 per accident, or hold an umbrella policy. This information is part of your automobile insurance policy. An insurance card alone does not provide all the necessary information.