Register Your ChildPlease fill out this form to register your child. * Denotes required items. FULL ADDRESSES INCLUDING POSTAL CODES ARE REQUIRED, PLEASE!Please enable JavaScript in your browser to complete this form.Program Selection* Toddler program operates Monday to Thursday * Two day program options are available Monday/Wednesday or Tuesday/Thursday. Exceptions may apply * Three day Pre-school program available Monday/Wednesday/Friday. Exceptions may apply. * If your program of choice is not available you may be placed on a waiting list. When do you want to join our Nursery School? *ImmediatelyLater DateApproximate Start Date:Class TypeToddlerPre-SchoolDays of the Week Attending *Enter which days of the week for child careTax Receipt Required?YesNoChild's InformationName *FirstMiddleLastDate of Birth *Address *Full Address Including Postal CodeGender *FemaleMaleXParent InformationDo both parents have custody of the Child? *YesNo - Parent 1 has sole custodyNo - Parent 2 has sole custodyParent 1's InformationName *FirstLastEmail *Address (if different from Child)Primary Phone *Secondary PhoneWork PhonePlace of Employment *Address of EmploymentAddress including Postal CodeParent 2's InformationNameFirstLastEmailAddress (if different from Child)Primary PhoneSecondary PhoneWork PhonePlace of EmploymentAddress of EmploymentAddress including Postal CodePhysician's InformationProvide information in case of emergencyPhysician's Name *FirstLastPhysician's Phone *Physician's AddressEmergency ContactsContact #1 Name *FirstLastRelationship *Phone *Address *Full Address including Postal CodeContact #2 NameFirstLastRelationshipPhoneAddressFull Address including Postal CodeIndividuals Authorized to Pick up ChildPeople authorized to pick up your child in your absence.Contact #1 NameFirstLastRelationshipPhoneAddressFull Address including Postal CodeContact #2 NameFirstLastRelationshipPhoneAddressFull Address including Postal CodeIndividuals NOT Authorized to Pick Up ChildList anyone NOT authorized to ever pick up your child.Not Authorized Contact #1FirstLastRelationshipNot Authorized Contact #2FirstLastRelationshipChild's Medical InformationThe Day Nursery Act 1986 Regulation 160, Section 7 (i) requires the following medical information. This information will be kept in your child's confidential file along with their registration package. Please fill out below. If there are none, simply type N/A or None.Allergies/Conditions *List Allergies and Conditions. If none, state "None"Reaction *Describe any reactions to look out forTreatment *Treatment protocolsCommunicable DiseaseIf your child has ever had a communicable disease such as Measles, Rubella, Chicken Pox or Whooping Cough? If Yes, please indicate which disease(s) and when.In the Event of an Emergency *In the event of an emergency, please advise as to an individual action plan and sequence it should occur (E.g. contact parent via cell, administer medication, dial 911) or state how circumstances would dictate depending on the emergency and it would of the discretion of the person responsible for your child.Special ConsiderationsDoes your child require any special considerations in respect to diet, rest or exercise? If yes, please describe.Physical DisabilitiesDoes your child possess any physical disabilities? If yes, please describe.Behaviour/EmotionalDoes your child possess any emotional disorder or behaviour problems? If yes, please describe.MedicationDoes your child require medication regularly? If yes, please describe.Other InformationHow did you hear about us?More about you and your childAny information you want to add about your child? As well, please indicate whether you possess any special skills/talents/opportunities that you feel may benefit Maple Nursery School or the children directly.ConsentI provide consent for Maple Nursery School to post photos of your child on our private Parent Facebook Group? *YesNoCLICK HERE FOR PARENT HANDBOOK I have received the Parent Handbook? Clickable link above that opens in a new window/tab. *YesNoAcknowledgementThe information given is true, correct and complete to the best of my knowledge. *YesDate of Submission *You will receive a copy of this application by the email provided in Parent #1 field.Submit Your Application