Online Registration

HIGHVIEW WILSON CHILDCARE CENTRE REGISTRATION FORM

Child’s Name:

Sex:
MaleFemale

Child’s Date of Birth:

Preferred Name:

Home Address:

Postal Code:

Home Phone:

Email Address:

Parent/Guardians

Parent Name 1:

Home Phone:

Home Address:

Work/School Address/Business Name:

Work Phone:

Cell Phone:

Parent Name 2

Home Phone:

Home Address

Work/School Address/Business Name:

Work Phone:

Cell Phone

Custody arrangements: Please state specifics of custody arrangements and provide a copy of the legal agreement. We must have a copy of any court ordered custody agreement
Sole Physical Custody
Joint Physical Custody
Restraining Order
Other

Family Doctor

Family Doctor

Phone Number:

Address

Other medical information:

Emergency Contacts

Name:

Relationship:

Contact Number:

Name:

Relationship:

Contact Number:

Parent Communication Information Sheet

Telephone numbers of who you would like information related to:

Name:

Contact:

Relationship:

Name:

Contact:

Relationship:

It is important for communication between the teacher and the parents whenever possible. Please keep us informed of any changes at home that may affect your child’s performance. We will also keep you informed.

Confidential Information

We greatly appreciate the answers to the following questions, as it will help in understanding and guiding your child.

Has you child/children ever attended Daycare, Nursery or a Babysitter?

What language is spoken at home?

Are there any words that would help your child feel more comfortable?

What is your child’s favorite food?

Does your child have siblings?

Are there any special diet, exercise for your child?

Would you like to add anything which you feel would be important to us?

Parent Consent

Parent consent for field trips:

I hereby consent to have my child leave the premises of Highview Wilson Childcare Centre, from time to time, to participate in excursions to places of interest, planned as part of the children’s program. This includes walk through the neighbourhood and playground. Parents will be notified of field trips in advance.

It is understood that the supervision will be provided by embers of the childcare centre and every precaution will be taken for the safety of my child. In the event of accident or injury, Highview Wilson Childcare Centre and staff members are hereby released from any liability.

Child’s Name:

Date:

Parent/Guardian Signature:

Medical Treatment

While every possible effort will be made to reach parents in the event of medical emergency, we require your permission to authorize any doctor of a necessary treatment in the event of such an emergency.

I hereby consent to medical treatment being given to my child, if at any time such treatment I necessary due to circumstances such as accident, sudden illness or emergency. Highview Wilson Childcare Centre and all staff members are hereby released from any liability due to circumstances and medical treatment received, as a result of such emergency.

Child’s Name:

Date

Signature of Parent:

Photographic release permission

I hereby consent and authorize Highview Wilson Childcare Centre to photograph my child for classroom and trip use only. I also consent to Early Childhood Education students and students in related fields to study to photograph my child in a group setting for the purpose of classroom assignments. Please check list below:

• Custody arrangements: Please state specifics of custody arrangements and provide a copy of the legal agreement. We must have a copy of any court ordered custody agreement

• Display photos in the Childcare Centre

• Co-op Students to use for assignments hands and background only

• Birthday Parties

I understand and agree to follow the policies outlined in HWCC’s Parent Handbook.

Start date:

Parent Signature

Date

Management’s Signature:

Date:

PICK UP PERMISSION FORM

Person’s Name

Relationship to Child

Parent/Guardian’s Signature:

Date: