Rooted Life Montessori Elementary Education

Rooted Life Montessori Summer Camp Application

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*Please select one of the following options.

Summer Camp Information

*Please choose your child's age group.

Emergency Contact Information

List telephone numbers below where parents or guardians my be reached while the child will be in care.

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Use the link below to download our Medical Verification form which needs to be brought in.


*By checking this box you acknowledge that you understand the time's that our summer camp operates.

*Please choose your payment method

Electronics Policy

Rooted Life Montessori does NOT allow any forms of electronics on the campus for the children enrolled: iPad, tablets, phones, cameras, gaming devices, or basically anything that accepts batteries or an electrical power supply.

1st offense: the device will be taken from the child and returned at the end of the day. (Parent will receive notification of the event, but the teacher will allow the child to remedy the situation)

2nd offense: the device will be taken from the child and must be retrieved by the parent.

3rd offense: the child will be excused from class immediately to be picked up by the parent. The child will not be able to return for 7 days (a tuition refund will not be allowed).

If the parent is unable to retrieve the child, the child will be released to an authorized adult on the child’s Authorization For Release Form.

*Parent Signature

A Parent Must Sign


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Photo and Video Release

*Please be advised that your child may be photographed or videoed during the school day. Review the options below on how you would / would not like your child's photos to be used. Please make a selection below.

Please make a selection.


*Parent Signature

A Parent Signature is Required.

Discipline and Guidance Policy

Discipline must be:

  1. Individualized and consistent for each child;
  2. Appropriate to the child’s level of understanding; and
  3. Directed toward teaching the child acceptable behavior and self-control.

The staff at RLM may only use positive methods of discipline and guidance that encourage self-esteem, self-control, and self-direction, which include at least the following:

  1. Using praise and encouragement of good behavior instead of focusing only upon unacceptable behavior;
  2. Reminding a child of behavior expectations daily by using clear, positive statements;
  3. Redirecting behavior using positive statements; and
  4. Using brief supervised separation or time out from the group, when appropriate for the child’s age and development, which is limited to no more than one minute per year of the child’s age.

There must be no harsh, cruel, or unusual treatment of any child. The following types of discipline and guidance are prohibited:

  1. Corporal punishment or threats of corporal punishment;
  2. Punishment associated with food, naps, or toilet training;
  3. Pinching, shaking, or biting a child;
  4. Hitting a child with a hand or instrument;
  5. Putting anything in or on a child’s mouth;
  6. Humiliating, ridiculing, rejecting, or yelling at a child;
  7. Subjecting a child to harsh, abusive, or profane language;
  8. Placing a child in a locked or dark room, bathroom, or closet with the door closed; and
  9. Requiring a child to remain silent or inactive for inappropriately long periods of time for the child’s age.

Texas Administrative Code, title 40, Chapters 746 and 747, Subchapters L, Discipline and Guidance

My signature verifies I have read and received a copy of this discipline and guidance policy.


A Signature is Required

*Check One Please

Please Make a Selection.

If you wish to go back and review any of your information, you may do so now. If all of your information is correct, you may submit the form now.

*By checking this box you acknowledge that you understand that no spots will be reserved until all camp fees and forms are submitted.