REGISTRATION PACKAGE INFANT / TODDLER / PRESCHOOL PROGRAMS


LEGAL PARENT/ GUARDIAN INFORMATION – SECTION 1


PARENT A

PARENT B





CUSTODY INFORMATION – SECTION 2


IF yes, a copy of the court order must be attached to this registration
Note: Childcare staff will make every effort to release children to only CUSTODIAL PARENTS Visits by non-custodial parents will not be allowed at the program.




EMERGENCY AND RELEASE CONTACTS – SECTION 3


Emergency Contacts and Authorization for Pick up List (not including parents/guardians) In the event of an emergency and we are unable to contact you please provide contact persons whom you authorize to pick up your child from the program. Please list these people in the order that you wish us to contact them.

I, give consent/authorization for the following people to pick my (name of parent/guardian) child, . I understand that any person whose name appears (name)

Below will be required to present picture identification prior to the child being released. I also understand that if their name does not appear on this list the child/children will not be released.

It is the responsibility of the parent/guardian to notify the Supervisor of changes made to this list.

Name Of person

Relationship

Phone Number







AGENCY INVOLVEMENT – SECTION 4

AGENCY - CONTACT PERSON

I, _____________________________________, hereby authorize the Latchkey Day Care and Learning Centre to exchange information with the above mentioned agency(ies) relating to all aspects of my child’s developmental progress.





Signature of Parent or Guardian




Witness (Supervisor or Designate)




Date




Date





HEALTH INFORMATION – SECTION 5



Allergies/Food Restrictions

Allergic Reaction(s)

Recommended Treatment



Parents must provide a copy of your child’s immunization card with a record of up to date immunizations.
Should your child not be immunized, proper documentation for reason/s must be included with this record.




Immunization Record Received.


Supervisor Signature:



AUTHORIZATION FOR EMERGENCY TREATMENT

If your child becomes ill or has an accident while attending our program, we will immediately inform you. If you are unavailable we will contact your designated emergency contact. In all situations every effort will be made to contact you. However the well-being and comfort of your child will be our first priority.


In the event of a medical emergency I understand first aid may be applied, and my child may be transported to a hospital through the use of an emergency vehicle.


In the event that I cannot be reached, I hereby give permission to the Program Supervisor / Designate where my child is enrolled to arrange to have (Name of Child)__________________________ transported to the nearest medical facility.

**Any medical expenses incurred will be the responsibility of the child’s family





Signature of Parent or Guardian




Witness (Supervisor or Designate)




Date




Date









GUIDANCE AND BEHAVIOUR – SECTION 6:




CONSENT FORM:

SUNSCREEN

I understand that program staff will follow safe sun practices. I will apply sunscreen before my child(ren) arrive each day. I give permission for the Centre staff to apply sunscreen on an as needed basis for the remainder of the day which I have provided.

Parent or Guardian Initials Required    Yes______ No______

INSECT REPELLENT LOTION

I grant permission to Program staff to apply insect repellent lotion, which I have provided for my child.

Parent or Guardian Initials Required    Yes______ No______

MEDIA RELEASE

I grant permission to Program staff to apply insect repellent lotion, which I have provided for my child.

Parent or Guardian Initials Required    Yes______ No______

OFF-SITE ACTIVITIES

I give permission for my child to take part in neighbourhood walks and other off site program activities in the walking vicinity of the program. I understand that my child will have the opportunity to participate in walks on a spontaneous basis. I will be notified in advance if any outing involves transportation.

Parent or Guardian Initials Required    Yes______ No______

ILLNESS

I will not send my child to the program if he/she is ill. If my child is absent I agree to immediately notify the program and advise them of the absence. If my child becomes ill while at the program, I will arrange to pick him/her up as soon as possible. I will notify the program immediately of any communicable disease that my child has contracted. If my child has been given prescription medication they cannot return until they have been on the medication for 24 hours.

Parent or Guardian Initials Required    Yes______ No______

PEANUT AND NUT AWARENESS

Latchkey Day Care and Learning Centre cannot and does not guarantee that the program environment will be free from nuts or other possible allergens, but will use its best effort to reduce allergy risks by creating an allergy-aware environment.
I understand that this program does not permit peanuts, peanut products and/or nuts on the premises. I agree that my child will not attend with above stated products.

Parent or Guardian Initials Required    Yes______ No______

SPECIAL NOTES

It is essential to keep the program Supervisor updated as changes occur that may affect the physical and emotional well-being of your child.
I understand that it is my responsibility to inform the program Supervisor in writing of any changes that should be made to my child’s registration form. For example: change of pick up persons, new allergies, new address or phone number, etc

Parent or Guardian Initials Required    Yes______ No______

I understand that if in the opinion of the program Supervisor, if group care at the Centre proves to be too stimulating for my child and he/she cannot cope, I may be requested to seek alternate care for my child.

Parent or Guardian Initials Required    Yes______ No______

REGISTRATION INFORMATION

*I have clearly indicated my selection on this consent form. I understand that it is my responsibility to advise the program Supervisor should my above noted preferences change.





Signature of Parent or Guardian




Witness (Supervisor or Designate)




Date




Date
I hereby consent to the collection; use and disclosure of my child’s information by the program for the purposes of providing child care services. I understand that the Centre protects the privacy of all personal information in its possession in compliance with prevailing privacy legislation.

Thank you for choosing Latchkey Day Care & Learning Centre

FEE AGREEMENT

Registration

There is a $30.00 non-refundable annual registration fee per family due every September. A non-refundable tuition deposit of $100.00 is required in order to confirm a space in the program. This deposit will be deducted from your first month’s tuition fee. Please note who will be invoiced.

Your selection will be reflected on your monthly statement as well as your annual income tax receipt.

both Parents   Parent A only   Parent B only  

TUITION – Infant Program (0 – 18 months)
Full Day Rate 1 Child = $44.00 2 Children = $84.00
Half Day Rate (less than 5 hours AM or PM) 1 Child = $33.00 2 Children = $62.00

TUITION - Toddler Program (18 months – 2.6 years)
Full Day Rate 1 Child = $39.00 2 Children = $74.00
Half Day Rate (less than 5 hours AM or PM) 1 Child = $28.00 2 Children = $52.00

TUITION - Preschool Program (2.6 years – 4 years)
Full Day Rate 1 Child = $35.00 2 Children = $68.00
Half Day Rate (less than 5 hours AM or PM) 1 Child = $23.00 2 Children = $44.00


TUITION PAYMENTS
Payment for all scheduled days for each month is required in advance by postdated cheque dated for the 1st of the month.
All fees for the full day or half day program are required in advance are nonrefundable unless you provide notification in writing, at least four weeks in advance, of changes in your schedule.

Parent or Guardian Initials Required ____________

SCHEDULES
Attending at least 3 full days per week is beneficial for educational experiences and opportunities. Priority will be given to families with children attending 5 days per week
Please mark the days and times you require services below:

AM (drop off time) ______________
PM (pick up time) ______________

Monday
Tuesday
Wednesday
Thursday
Friday

Parent or Guardian Initials Required ____________

SCHOOL BREAKS, PD DAYS/ STATUTORY HOLIDAYS

The program will operate during Christmas, March Break, PD days and summer, if there is sufficient demand for child care during these times. Please speak to the Latchkey Day Care Supervisor to plan for these days and times in advance.
All Latchkey Day Care & Learning Centre programs will be closed on the following statutory holidays:

* Labour Day
* Thanksgiving Day
* Christmas Day
* Boxing Day
* New Year’s Day
* Family Day
* Good Friday
* Easter Monday
* Victoria Day
* Canada Day
* August Civic Holiday

NON-SUFFICIENT FUNDS
All cheques returned to the Corporation as Non-Sufficient funds (NSF) will have a charge of $35.00. All other bank charges or fees acquired as a result of returned items will be passed on to the Parent/Guardian accordingly. All monies will be paid within FIVE (5) days of notification, including the $35.00 NSF fee, in the form of a certified cheque, money order, or cash. In the event that a second cheque should come back as NSF, all child care fees from that day forward will be paid by certified cheque, money order or cash.

LATE FEES
There will be a severe late penalty for any child who is not picked up by 6:00 p.m. Between 6:00 p.m. and 6:15 p.m., there will be a $10.00 late fee per child and $1.00/child for every minute after this. IF YOU ARE LATE ON 3 OCCASIONS, YOU WILL
BE ASKED TO FIND ALTERNATIVE DAY CARE ARRANGEMENTS.

ARRIVAL AND DEPARTURE
Children are to be escorted into the building using the designated entrance. The child shall be signed in and out by an escort, someone 16 years or older. No child shall be released to a person not authorized by a parent. We must have written or verbal consent for changes in this respect.

ANNUAL GENERAL MEMBERSHIP MEETING AND BOARD MEMBERS
Parents are required to attend or be represented by proxy, at the Annual General Membership Meeting held each April.

FUNDRAISING
During the year a number of fundraising events are held in order to purchase games, toys, books and recreational equipment. Please let us know if you have an idea for an event. This will help to keep parent fees down. In lieu of participation of the fundraiser events donations are accepted and an income tax receipt will be given.

SPECIAL NOTES
The Board of Directors reserves the right to make changes to fees at their discretion. Notice of 30 days will be given informing parents of any changes.

Parent or Guardian Initials Required ____________

Accounts not paid according to the outlined agreement will result in suspension of care until payment is secured. All accounts that are 45 days past due will be forwarded to a collection agency.

Parent or Guardian Initials Required ____________

Latchkey Day Care does not issue credits for sick days, vacation days, or any unexpected centre closures.

Parent or Guardian Initials Required ____________

Repeated behavioral difficulties and lack of Parental/Custodial support may deem it necessary to discontinue a child’s enrollment in the program

Parent or Guardian Initials Required ____________

I have read and fully understand the entire Parent handbook. I have also completed the enrollment application in FULL and have attached the necessary information.

Parent or Guardian Initials Required ____________





Signature of Parent or Guardian




Witness (Supervisor or Designate)




Date




Date
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