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PRESCHOOL CHILD IDENTIFICATION

    Child's Name*
    Child's Birthdate*
    Child's Eye Colour*
    Child's Hair Colour*
    Child's Skin Colour/Ethnicity*
    Parent's Signature*
    Date*
    Attach Photo of Child

    PRESCHOOL EMERGENCY RECORD

      Child's Name
      D.O.B
      Gender
      Address
      Postal Code
      Health Care #
      Parent(s)
      Home #
      Work/school #
      Emergency Contacts
      Home #
      Work/school #
      Physician
      Office #
      Address
      Allergies
      Health Problems
      In case of accident, injury or illness, i authorize to contact a physician and/or ambulance and to seek medical attention for my child. I also consent for my child to be transported by ambulance or in a staff vehicle to obtain medical attention.
      Parent's Signature*
      Date*

      PRESCHOOL REGISTRATION

        Child's Name*
        Birthdate*
        Nickname
        Sex

        Age

        Yrs

        Mos
        Enrollment Date*
        Withdrawal Date*
        Mailing Address
        Street Address
        Email Address
        Mother's Name
        Home #
        Cell #
        Work #
        Father's Name
        Home #
        Cell #
        Work #
        Parent's Occupation
        Languages spoken at home
        Person to call in case of accident (other than parents listed above)
        Phone #
        Persons authorised to pick up child from facility (other than parent/guardian)
        Name
        Relationship to child
        Phone #
        Name
        Relationship to child
        Phone #
        Name
        Relationship to child
        Phone #
        Family Physician
        Phone #
        Personal Health Number
        Child Immunization
        Rubella

        Health

        General

        Allergies
        Any Allergy/Reactions/Treatments
        Illness or Medical Treatments
        Is there anyone not permitted to pick up your child?

        Family

        Adults at home

        Siblings
        Pets
        Child's previous experience in a playgroup?
        Child's special likes
        What do you hope your child will gain from preschool?
        If there is a custody agreement, please give details. A copy of the custody order must be left with the preschool staff.
        Signature*
        Date*
        Would you like some information about Preschool Subsidy for Fees?
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