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Petits Poussins Brooklyn

Bilingual French Pre-school1656 Third Ave., New York, NY 10128 Tel/Fax: 212-410-0180


Your child must be 2.0 years old and toilet trained by Sep. 1st to be accepted in the program.

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Guardian 1

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Guardian 2

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September - June

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Medical Statements and Consent

Arc-En-Ciel is not permitted to administer any medication, if needed, please do so at home or after school.

I (we) authorize staff and Director of Arc-En-Ciel Preschool to obtain all necessary Emergency Medical treatment, in case of an emergency.

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Note: All allergies/medical conditions must be stated on the child's medical form. Additionally, a "Standing Order" from the Pediatrician will be required in order to administer an Epi-Pen, Benadryl, or any Asthma medication. Your child will not be admitted without it.

New York department of health requires that all children are vaccinated for school entrance.

I, hereby, authorize Arc-En-Ciel Preschool to provide care for my child.

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I declare to the best of my knowledge that all statements made in this application are true.

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