Forms

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Registration Forms

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  • BUSY BEES NURSERY SCHOOL
  • REGISTRATION FORM
  • 168 KENNEDY ROAD SOUTH, BRAMPTON, ONTARIO L6W 3G6 TEL (905 454-7676
  • Busybees011@outlook.com
  • www.busybeesbrampton.com
  •  
  • Date:
  • Child’s Surname:                                                            First Name:
  • Address:
  • Home Phone Number:                                                  Birth Date D/M/Y: 
  • Email address:___________________________________________.
  •  
  • Parents or Guardians
  • Mother’s Name:                                                             Father’s Name:        
  • Name of Business:                                                         Name of Business:    
  • Business Address:                                                          Business Address:                                                   
  • Business Phone:                                       Ext                Business Phone:                                       Ext                                  
  • Occupation:                                                                     Occupation:                                                                   
  • Emergency Names (In case of an emergency and the parents cannot be contacted)
  • Name:                                       Phone:                                       Relation:
  • Name:                                       Phone:                                       Relation:
  • Name:                                       Phone:                                        Relation:
  • Family Doctor:                                                                  Tel:
  • Address:
  • Other Information: Please describe allergies, Communicable diseases (Chickenpox, measles) Special diet, physical and behavioural problems. Special interests or major changes on the family or any other information that might help us to get to know your child better.
  •                         
  • Program Required:
  • Toddler:                      Preschool:                 JK/SK:
  • Teacher’s Name:                                            School:
  • Time of Arrival:                                             Time of Departure:
  • Person authorized to pick up child:
  • Name:                                                
  • Business Phone:
  • Relationship:                                       Home Phone:
  • Name:                                                    Business Phone:
  • Relationship:                                        Home Phone:
  •  
  •  
  • NOTICE WITH RESPECT TO THE COLLECTION OF PERSONAL INFORMATION
  • Municipal Freedom of Information and Protection of Privacy Act
  • Children’s Records in Directly Operated
  • Personal information is collected under the authority of the Day Nurseries Act, R.S. O. 1990, c.D2s. 3(1), and
  • R.R.O. Regulation 262.  This information will be used to maintain mandatory up-to-date records required by the Day Nurseries
  • Act.  Questions about the collection of this information should be directed to the Centre Supervisor
  •  
  • Consent, Parental Acknowledgement and Release
  • CONSENT TO MEDICAL TREATMENT
  • In the event of any illness or injury to my child while my child is in the care of the Centre, I give my consent and authorize staff to administer First Aid to my child in accordance with Centre staff’s First Aid training.  If Centre staff are of the opinion that my child requires urgent medical attention, beyond the scope of Centre staff’s First Aid, I give my consent and authorize Centre staff to seek emergency medical care for my child and to transfer care of my child to emergency medical practitioners.  Centre staff will make every effort to contact me as soon as possible in the event of any emergency.   
  •    Signature _______________________    Date _________________                                                                                       
  •  
  • CONSENT TO RELEASE OF CHILD
  • I understand that it is my responsibility to advise the Centre supervisor or designate immediately in writing if there are any changes to the emergency contact information contained on my child’s admission form. I give my consent and authorize Centre staff to release my child at any time to any individual listed as an emergency contact on my child’s admission form without any further notice or instructions from me.
  • Signature _______________________    Date __________________                                                                                       
  • In the event of an emergency, I give my consent and authorize the Centre supervisor or designate to release my child to an individual who has not been listed as an emergency contact on my child’s admission form. Where written authorization is not possible then the Centre supervisor or designate would accept the name and verbal description of the designated emergency caregiver and will verify their identification.
  • Signature _______________________    Date __________________    
  • CONSENTS
  • Community Excursions: I give my consent for my child to participate in neighbourhood excursions under teacher supervision.  Yes/No         Initial ____
  • Sunscreen: I give my consent for Centre staff to apply sunscreen, supplied by myself, onto my child.                                         Yes/No          Initial ____
  • Lotions: I give my consent for Centre staff to apply non- medicated creams or lotions supplied by myself onto my child.                     Yes/No    Initial ____                                                                                                     
  • Child’s work: I give my consent to Busy Bees Nursery School to include my child’s work on their website, displays, newsletters, brochures, communications, videos, newspaper articles or any other form or medium which may be released to the public for the purpose of promoting Regional Child Care programs or any other similar purpose.
  • Yes/No            Initial ____
  • Audio and Visual Recordings/Photographs of Child:  I give my consent to photographs and other audio and visual recordings being taken of my child in the Centre’s care and I further consent and give my permission to Busy Bees to use, display, publish and distribute photos and recordings:
  • via the Busy Bees website, display, newsletters, brochures, communications, videos, newspaper articles, or any other form or medium which may be released to the public for the purpose of promoting Busy Bees Child care programs or for any similar purpose. Yes/No       Initial ____
  • for the purpose of classroom activities Yes/No           Initial ____
  • for the purpose of classroom activities including class/group photos and photos for memory books etc., which may be distributed to other families at the Centre. Yes/No           Initial ____
  • for administrative and safety purposes such as updating the child’s file, photographing the children prior to off-site excursions etc.
  •           Yes/No           Initial _____
  •    If my child becomes ill at the Centre, I will be notified. If requested, I understand and agree that it is my responsibility to pick up my child or arrange for an emergency contact person immediately. I understand and agree that if my child is not well enough to participate in all components of the program, including outdoor play, then I am responsible for arranging alternate child care.                                                                                Initial ____
  • Parents/Guardians are encouraged to administer medication at home whenever possible. If Centre staff agrees to administer medication at the Centre, a Medication Authorization form must be completed prior to administration of the medication.
  •                                                                                                      Initial ____
  • I understand that for health and safety purposes, the Centre does not permit children or parents to bring food into the Centre. I agree that I will not bring, and I will not allow my child to bring food into the Centre. I will also ensure that my child’s clothing and backpack does
  • not contain any food items or medication. 
  •                                                                                                 Initial ____
  • I acknowledge that reasonable efforts have been taken to provide an allergen free environment at the Centre; however I understand the Centre cannot guarantee an environment free of all allergens. I acknowledge that my child may inadvertently come into contact with a substance that s/he may be allergic to and that such contact may result in an allergic reaction. I understand that there are certain risks of allergen contact in a child care setting.                   
  • Initial ____
  •       PARENT HANDBOOK
  • I confirm that the Centre supervisor or designate has reviewed with me the details contained in these sections of the Parent Handbook:
  • Arriving at the Centre ____     initial 
  • Leaving for the day _____  initial
  • Giving Medicine _____ initial
  • Child Abuse Reporting ____  initial
  •  
  •  I confirm that I have received and read the Parent Handbook in full. I understand and agree to abide by all of the parent responsibilities and policies outlined in the Parent Handbook as a condition of receiving childcare for my child.
  • Initial _____                           
  • RELEASE/ WAIVER/ INDEMNITY
  • In consideration for the provision of child care services, I hereby agree to release, waiver, forever discharge, save harmless and keep indemnified Busy Bees (including its employees, officers, elected officials, volunteers, representatives, agents and all those for whom it is legally responsible) from and against any and all claims, actions, damages, costs, expenses, losses and liabilities, of any kind whatsoever, and howsoever caused, arising from, or in connection with, the provision of child care services, unless same is caused by the sole negligence of Busy Bees.
  • ______________                                ___________________________
  • Date                                                   Signature of Parent/Guardian
  • _______________                            ______________________________
  • Date                                                    Signature of Parent/Guardian
  • ______________                                ______________________________
  • Date                                                       Signature of witness
  • ____________________________________________________________________________
  • For Office use only
  • Registration Fee Received: Amount $_____________Date ___________                             Key Deposit: $___________Date__________ two weeks deposit   $_____________________ Date_______________.

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