Download Pre-K Registration Form (PDF)
Name
Date of Birth
Address
Home Phone Number
List siblings and birthdays
Address (if different from above)
Work Phone Number
Cell Phone Number
Email Address
Occupation
Place of Employment
Who will be picking up your child?
*Please inform me if someone other than the above will be picking up your child.
Is your child toilet trained? YesNo being toilet trained is strongly recommended
Has your child ever been enrolled in a day care, nursery school or public school program before? YesNo
If yes, briefly explain this experience:
Rate on a scale of 1-10 (1-low priority, 10-high priority)
To have some time to yourself ---12345678910
Social Development ---12345678910
Academic Development ---12345678910
Physical Development ---12345678910
Emotional Development ---12345678910
Spiritual Development (learning about the love of God, Bible stories and verses, talking to God through prayer) ---12345678910
State any other reason you wish to enrol your child in this program.
What are your child's favourite toys?
What are your child’s favourite TV shows?
What are your child’s favourite times during the day?
Where does your child choose to play most often?
Has your child had any experience with animals? YesNo
What opportunities has your child had to play with others?
What are your child’s special interests and activities?
Where does your child enjoy going with you?
What books does your child like to read?
What do you enjoy most about your child (imagination, sense of humour, language)?
Is there anything else you would like to tell me about your child?
Child's Name
Health Card Number
Family Doctor
Phone Number
Are all immunizations up to date? YesNo
Does your child have any allergies that you are aware of? YesNo
If so, what are they?
What are the symptoms?
What is the treatment?
Is your child on any medications at present? YesNo
If so, what?
What is it for?
Does your child have frequent: coldsstomach achesheadacheshigh feverear infections
Has your child had any of the following assessments? speechhearingvision
If so, when? Briefly explain the outcome.
Are there any other medical conditions or limitations, which I should be aware of?
I consent to the participation of my child in activities related to the school program and field trips with “Treasured Kids School” throughout the year. (This may include an occasional hike to the neighbourhood park or short walks in the neighbourhood.)
Signature (print name)
I give permission for occasional photos and/or videos to be taken of my child while at “Treasured Kids School”. This could be while the children are on a field trip as well. These are often a good way for parents to see what their child does while at school.
In case the opportunity arises, I give permission for my child to have his/her photo taken for media coverage in local newspapers and have his/her name published.
I give permission for photos of my child to be posted on the Treasured Kids Website Photo Gallery.
I grant permission for Sharon Kelsall to take whatever steps may be necessary to obtain emergency medical care.
I have read and understand the policies stated in the enrolment package. I have completed and signed ALL forms included in the package.
I agree to pay the monthly sum of $135 which is due on the first of each month (September-June) by e-transfer to sharon@kelsall.ca.
I understand that this amount is averaged out over the year, so that the same amount is paid each month, even though the number of days per month will vary.
In order to reserve a place for my child at Treasured Kids School I agree to pay the non-refundable registration fee of $80 by e-transfer to sharon@kelsall.ca (or cash) upon completion and submission of these enrolment forms.
If for any reason you wish to withdraw your child from this program, a refund for the remaining amount of time will be issued, minus a two-week grace period.
If for any reason it is not in the best interest of the school or other children enrolled in the program to have your child in attendance, it may be necessary to withdraw your child from the program. A refund for the remaining amount of time will be issued.
I accept the above terms
Your Email Address
