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Junior Kindergarten

REGISTRATION FORM

Persons Authorized to pick up child from Child Care and Emergency contacts(other than parents):

Please Note: We Will Not Release Your Child To Anyone Who Is Not On The List
If we have not seen/met person on the list we will need a picture ID with full name of individual
before we release the child. Your emergency contact will be contacted in case of emergency if
you cannot be reached.


Sibling Information

Tell us about your child;

Guidance and Behaviour


Health Information

Immunizations:Please fill the dates or Attach copy of health book

Age DTaP-HBIPV-Hib Pneumococcal MMR Meningococcal C Varicella Rotavirus Influenza Help A
2 mos N/A N/A N/A N/A
4 mos N/A N/A n/a N/A N/A
6 mos N/A N/A N/A N/A N/A N/A
12 mos N/A N/A N/A
18 mos N/A N/A N/A N/A N/A N/A N/A

Past Illnesses:

If your child has Allergies (Mid or services) Please Sign the following Two forms:
1. Allergy anaphylaxis forms
2.Allergy data collection form


KIDZVILLE LEARNING CENTERS
CONSENT FORMS & CHILDCARE AGREEMENT

to take part in the following:


Italian Trulli

www.kidzvillelearningcenters.com

info@kidzvillelearningcenters.com

www.facebook.com/PRmontessori

PH : (604) 861-7861

CONSENT FORM NATURE WALKS AROUND SCHOOL

to take part in Nature

Walks around and near the school grounds. I know that all safety measures will be in place and the staff of Kidzville will be present on such trips and outings. I waive all liabilities from Kidzville Learning Center in case of any accidents or injury that may
occur.


Italian Trulli

kidzvillelearningcenters.com

info@kidzvillelearningcenters.com

www.facebook.com/PRmontessori

PH : (604) 861-7861

CONSENT FORM

It is the policy of this center to notify a parent when a child is ill or needs medical attention.In the event we cannot contacr you and we need to get help for your child we require a signed consent to do so.

1. I give consent for my child to be taken to the nearest emergency medical center when i cannot be contacted.
2. I give consent for my child to receive medical treatment.

Personal information contained on this form is coolected under the community care and Assisated living Act and willbe used only for the purpose indicated.

Italian Trulli

EMERGENCY CONSENT CARD

Kidzville Learning Centers

Name of Facilty


Italian Trulli

Parent Agreement

I have received and read the parent handbook and am aware of the policies and procedures of the school. This is a
valid contract between me and Kidzville Learning centres and I agree to abide by the policies of the school. I also
understand that failure to comply by these rules could result into withdrawal of my child from Kidzville Learning
Centers