Out of school care enrollment forms

Enrollment Form No.:

ELECTRONIC SIGNATURE: DISCLAIMER

If you intend to electronically sign the following form, please read this carefully before signing.

By signing your name electronically on last of this form, you are agreeing that your electronic signature is the legal equivalent of your manual signature on this Form. You will receive a copy of this application after it has been Submitted. Thank you for you interest in Superlearners Childcareland.

PHILOSOPHY

Superlearners Childcareland strives to create a caring, healthy, educational, and friendly environment that allows children to realize their full potential in all areas of growth and learning. We promote a safe environment that encourages learning while also catering to a child's fundamental need for play and enjoyment.

We value the uniqueness and individuality of all children and allow each child to develop at his or her own pace. Superlearners Childcareland embraces and celebrates the diversity of all children – ethnically, racially, linguistically, and developmentally.

We believe that children learn best through active participation. We strive to provide a wide variety of age-appropriate learning opportunities and experiences. We also plan our activities to meet the needs of all children and ssbase our curriculum on research-based learning methods. Both our physical environment and the way our teachers and staff communicate with children reflect our deep respect for them.

PARENT/CHILDCARE PROVIDER CONTRACT

Child Information

Child's Name

Select Gender
MaleFemale
Telephone

Date of Birth

Enrollment date

Select Fulltime/Parttime

140

Mother Information

Mother Name

Telephone

140

Father Information

Father Name

Telephone

140

Two people who can be called in an emergency if parents cannot be reached

1st Name

2nd Name

Relationship

Relationship

Telephone

Telephone

Please Note:

Children will be released to the parent(s) who register their children in the center.

CHILDREN WILL NOT BE RELEASED TO ANYONE NOT LISTED ON THIS FORM, UNLESS WE ARE ADVISED OF THE CHANGE IN WRITING.

MEDICAL INFORMATION

Care Card Number

Family Doctor

Phone

Is your child on any kind of medication? YESNO
if yes please describe

Does your child have any allergies? YESNO
if yes please describe

I/We hereby authorize Superlearners Childcareland to give any and all medical attention with respect to my child. I give my permission for my child to be taken to the hospital emergency if necessary. I will be responsible for all cost of ambulance transfer.

IMMUNIZATION

Your child must have immunization for :

DiphtheriaPertussisTetanusPoliomyelitisHIB (Meningitis) MeaslesMumpsRubella

YESNO

My child has Immunization for all of the above to the best of knowledge.

PARENT CONTRACT

ARRIVAL

Superlearners Childcareland will open at 7:00am. If you are unable to make it for the time agreed upon registration, then a phone call is necessary so that we know that your child will not be attending that day. Anyone showing up late without a phone call could be turned away or they might find that no one is at the center.

CLOSING

The daycare will close for the day at 5:30 pm. All children and staff should be out of the facility at 6:00. I do understand traffic, sudden bad weather, but if you know that you are unable to pick your child up by 6:00, then please make alternate arrangements to have your child picked up on time. The staff must be notified if this person is not on the pick-up list. This person must be prepared to show I.D. Late charges are $1 per minute and must be paid immediately and directly to the staff on duty.

Time Away from the Centre

If at any time your child is absent from the daycare for holidays, sickness or any other reason, parents must pay their fees in order to secure your child’s space in the center. We are providing a service and must be paid the same regardless if your child is in attendance or not.

FEES

The monthly fee per child is: $

for full-time child care.

Fees are paid prior to the 1st day of the month and stay the same regardless of how many days are in the month. Parents are required to submit a series of post-dated checks for the first of each month. This will avoid paying late charges of $5 per day, if the fees are not paid by the first of the month. Checks, money orders or bank drafts are preferred. Receipts are given so please keep them safe for your tax purposes. All N.S.F. checks are subject to a $30 charge. If fees are not paid, care will not be provided to your child and your space could be filled.

CENTRE CLOSURES

Superlearners Childcareland will be closed for all statutory holidays, Boxing Day and Easter Monday plus same days as the public school during Christmas holidays. The monthly fee is still the same as staff must also receive pay for statutory holidays.

CHANGE OF INFORMATION

It is the responsibility of the parent to inform the daycare in writing of any changes that should be made to their child’s registration form. For example: change of pick up persons, new allergies, new address or phone number, etc.

WITHDRAWAL

Withdrawal requires a full month’s notice in writing which must be given the first of the month. Failure to give one month’s notice will result in the parent being required to pay the full month’s fee. No refund of deposit will be given.

CONSENT FORMS

I/We give permission for my child to take part in any field trips or other activities which may require leaving the childcare center premises. It is my understanding that these outings will be well supervised, and all possible precautions will be taken to ensure the safety of the child.

I/We hereby give permission and authorize Superlearners Childcareland and to obtain or provide all medical attention with respect to my child, if necessary. If my child has to be transported to hospital, I will pay for the ambulance fees.

I/We give permission for my child to take part in all outings from the daycare where a car or bus may be the form of transportation. Seat belts and booster seats will always used while in any vehicle

I/We give permission for my child to take part in any picture or video taking while in the care of the staff at Superlearners Childcareland I understand that pictures or videos may be used for public viewing, in local papers, or on television.

I/We agree to pay a monthly fee of ______________ for care payable on the first of each month. I/We agree to pay Superlearners Childcareland a deposit of ½ month fee. I/We agree to give Superlearners Childcareland one month’s written notice should I/We no longer require child care services.