Child Registration Form

Our curriculum is the Teaching Strategies GOLD curriculum; an authentic, ongoing observational system for assessing children from birth through kindergarten.
Child Registration Form



EMERGENCY INFORMATION (if parents cannot be reached)

*Appropriate paperwork such as custody papers shall be attached if a parent is not allowed to pick up the child. NOTE that section 22.1-4.3 of the Code of Virginia states that unless a court order has been issued to the contrary, the noncustodial parent of a student enrolled in a public school or day care center must be included, upon the request of such noncustodial parent, as an emergency contact for events occurring during school or day care activities.



  1. Vine & Branches CDC agrees to notify the parent(s)/guardian(s) whenever the child becomes ill and the parent(s)/guardian(s) will arrange to have the child picked up within one hour.
  2. The parent(s)/guardian(s) authorize Vine & Branches CDC to obtain immediate medical care if any emergency occurs when the parent(s)/guardian(s) cannot be located immediately.**
    **If there is an objection to this you must provide us with a statement stating the objection and the reason for objection
  3. The parent(s)/guardian(s) agree to inform the center within 24 hours or the next business day after his child or any member of the immediate household has developed a reportable communicable disease, as defined by the State Board of Health, except for life threatening diseases which must be reported immediately.
4. The parent(s)/guardian(s) authorize Vine & Branches CDC to release photographs of his child, which can be used for the following purposes (initial all that apply below):
5. The parent(s)/guardian(s) authorize Vine & Branches CDC to release our contact information (email addresses) to the other parents in our child’s classroom(s).