Mandatory Forms

FormWho must complete the form?
Health Assessment Record-up to 5 yrsAll Currently Enrolled Children up to 5 years old.(form is valid for one year from date of exam)
Health Assessment Record-over 6 yrs All Currently Enrolled Children over 6 years old.
(form is valid for one year from date of exam)
Enrollment & Emergency FormAll Currently Enrolled Children
Authorization for the Administration of MedicineAll Currently Enrolled Children
with allergy &/or asthma
Emergency Health Care PlanAll Currently Enrolled Children
with a life-threatening allergy &/or asthma
Religious Exemption StatementAll Currently Enrolled Children who have elected out of immunizations must complete this form and have it notarized

For your registration to be considered complete, you must submit all necessary forms. Please consult the table to determine which forms you need. Health Assessment Forms are valid one year from date of exam.

Please return completed forms to the Darien Nature Center 2 weeks prior to your child’s start date. Forms will be reviewed and you may be contacted for further information.

Forms may be returned by email, fax, mail or dropped at the Darien Nature Center.

Darien Nature Center
120 Brookside Rd
Darien, CT 06820
203.655.7459 phone
203.655.3185 fax