Registration form

Child Information




MaleFemaleOther


yesno(If YES, you must provide legal document)



PARENT/GUARDIAN 1














PARENT/GUARDIAN 2















(for school correspondence)

EMERGENCY CONTACT & AUTHORIZED PICK-UP (other than parent/guardian)







ADDITIONAL AUTHORIZED PICK-UP







DOCTOR INFORMATION




MEDICAL INFORMATION


YesNo



YesNo


ALLERGIES


YesNo


PeanutsTree NutsEggDairyInsect Stings


FOOD RESTRICTIONS (Non-Life-Threatening Restriction)

VegetarianVeganHalalKosherNo PorkNo FishNo EggNo Beef


IMMUNIZATION RECORD

The student’s CURRENT immunization information is compulsory. A copy of the student’s immunization record is requested. If a copy of the immunization record is not available, please complete the table shown below.

Diphtheria

Tetanus

Pertussis

Polio

Hib

Pneumococcal

Rotavirus

Measles

Mumps

Rubella

Varicella

meningococcal

Hepatitis B

HPV

Influenza

HepatitisA

Other

Yes, my child is fully immunized and a copy has been provided to the schoolNo, my child has not been immunized and a copy was provided of either:

Statement Of Religious Or Conscience Belief FormStatement Of Medical Exemption FormStatement Of Religious Or Conscience Belief Form

CREAMS/OINTMENTS AUTHORIZATION

All non-prescription creams/ointments must be given in the ORIGINAL container(includes but not limited to Vaseline, Penaten, Sudo Cream, etc.)




Diaper areaBum



Every diaper changeWhen bum appears red


SUNSCREEN APPLICATIONAUTHORIZATION

Montessori School House does not accept sunblock with Arachidyl alcohol (peanut oil). Aveeno sunscreens other than Aveeno BABY brand have been known to include this ingredient therefore we are unable to accept them

I hereby give permission for the staff at Montessori School House to apply sunscreen when my child will be playing outside. I understand that sunscreen will be applied prior to going outdoors including, but not limited to the face (except eyelids, tops of ears, nose and exposed arms and legs.

Please apply sunscreen to my childPlease do not apply sunscreen to my child

If yes. Specify Brand

Permission

I the parent / guardian of

OUTINGS:give permission for my son/daughter to leave the premises to participate in any of our school events and places of interest as planned as part of the children’s program during the school year, including neighborhood nature walks. Parents will be notified of any field trips in advance.
PHOTOS:give permission for my child’s photograph to be used for school activities and school purposes only.
SLEEPING COTS:give permission for my child to use a sleeping cot if my child is 3.8 years of age or younger during rest time.
MEDICAL TREATMENT: authorize any doctor of a necessary treatment in the event of an emergency. MSH may be required to contact emergency help before attempting to reach parents. Parents will be immediately notified after emergency help is notified first. MSH and all staff members are hereby released from any liability due to circumstances and medical treatment received, as a result of such an emergency.

I have read and understood the terms above;



MEDIA RELEASE

I give Montessori School House permission to post photos and/or videos of my child on their private Instagram account(@MSHMaple). I understand these photos & videos will be used when creating the year-end school video. I understand that the school video can potentially be posted on the school’s website (www.montessorischoolhouse.ca)I DO NOT give Montessori School House permission to post photos or videos of my child on the private Instagram account & school website. I understand that my child will not be featured in the year end school video



DAYS OF ATTENDANCE / PROGRAM SELECTION

CASA PROGRAM (3 year program includes, preschool, JK SK)

5 full daysBefore care5 half dayAfter Care

TODDLER PROGRAM

5 full days5 half day

Infant PROGRAM

5 full days5 half day4 days3 days2 days

10 month program
12 month program



TERMS OF CONTRACT

All new applicants must pay a $250.00 registration fee which is non-refundable. This is a one-timefee
Security Fees are non-refundable
With all methods of payment, the last month’s fees are due at time of registration or re-enrollment(non-refundable)
All post-dated cheques must be dated for the first of each month and should include the child’s name on them
Written notice of a child’s withdrawal must be received 45 days prior to the intended date, otherwise 2 months tuition will be withheld.
There are no refunds/credits/make-up days for mid-month withdrawals, holidays, sick days,days missed or any other reason throughout the school year.
There are NO REFUNDS on lump sum payments.
There will be a $35.00 levied against all N.S.F. cheques or cheques returned for any reason. Where the appropriate replacement cheques or cash are not provided, Montessori School House reserves the right,which is not subject to challenge, in its sole and un fretted discretion to request the withdrawal of the child(ren).
The appropriate tax receipts will be remitted at the end of February.
There is a late pick up charge which is applied at the rate of $1.00/ minute after 6:00pm,or at any time that a teacher has to remain beyond established hours to care for a child due toa tardy parent/guardian
The enrollment policy is as follows:Parents/Guardians of children within the 5 full day program returning for another year have priority over all other programs offered, as well as new applicants until March 30th. If the administration fee(s) and post-dated cheques have not been received by this date, new applicants will be processed from our waiting list on a first-come-first-serve basis. You will forfeit any guarantee of placement
THIS REGISTRATION FORMIS CONTINUANCE OF EACH YEAR UNLESS A WRITTEN WITHDRAW NOTICE IS SUBMITTED TO THE OFFICE NO LATER THAN MAY 30th OF EACH YEAR
This is a legal and binding contract





I agree that typing my name in the Parent/Guardian fields on this agreement is the legal equivalent to a handwritten signature