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North Coast Nature School Interest Form
Please fill out if you are interested in enrolling. We will be in touch if we have a space that works for your family's needs!
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Parent/Guardian Name:
*
Your answer
Contact Email and Phone Number:
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Your answer
Child's Name:
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Your answer
Child's date of birth:
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Why is your family interested in our program (play-based learning; clean air; outdoor setting; something else)?
Your answer
Has your child had any previous experience in childcare or with a babysitter? Please describe:
Your answer
Is your child potty independent?
*
Yes
Not yet
Other:
What are some of your child's interests or favorite activities?
Your answer
What are some of your child's strengths?
Your answer
Do you or your child have any concerns about school?
Your answer
What do you hope your child will gain from being in a nature-based program?
Your answer
Is there anything else you would like us to know about your child?
Your answer
Our current schedule is half days Monday through Thursday. We generally have four or two days options, with occasional flexibility. What schedule/s are you interested in? Check all that apply.
Four days a week
Two days a week
Three days a week
Other:
Is there any other important scheduling information?
Your answer
New childcare rules being created in Oregon may allow us to operate longer days and offer part-time programming for homeschooled children beyond the age of 6. If it becomes possible, would you be interested in any of the following?
Interested in adding an hour to the day
Interested in school-age program (now or in the future)
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