Joyous Hearts Preschool & Daycare Centre Registration Form semester 3 2020-2021

Joyous Hearts Preschool & Daycare Centre

April -July 2021 Semester
Students name

First NameMiddle NameLast Name
Gender
Date Of Birth

MonthDayYear
What is the date of birth of the child being registered?

Pick-up List

If you are unable to pick-up your child/children/ward at the time of closure or on any day of the school week, please give the full name, address and contact number(s) of the person/persons that will be responsible for doing so.
I, First Name* Last Name* , the parent/guardian of, Child's First Name* Child's Last Name* , give consent to (1) First Name Last Name and (2) First Name Last Name to pick-up my child/children/ward from the Joyous Hearts Preschool and Daycare Centre.
Signature
Date

MonthDayYear
Today's Date

Student's Medical History
Is he/she potty trained?
Is he/she fully immunized?
Is he/she allergic to any food or drink example (milk, fish, egg, etc.)
N/A if no known allergies
Additional Comments/
Information which would be helpful in the provision of care

Emergency Contacts

Emergency Contacts should be someone that we can be in contact with other than a parent/guardian. A family member is preferred, however if there is no one available, it is still important to include a contact number in the event that parents/guardians are unreachable. We will always contact the main parent/guardian first.
Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship
What is the person to the child/parent/guardian?

Pre-School Advertising

How did you originally hear about the Joyous Hearts Preschool & Daycare Centre?
Other

Enrollment Agreement
I,First Name* Last Name* , the parent/guardian of Child's First Name* Child's Last Name* , on Date* agree to my child/ward attending the Joyous Hearts Preschool and Daycare Centre.
Signature
Should be Empty:

Joyous Hearts Preschool & Daycare Centre