GUC PLAYSCHOOL Registration 2022-2023

Schedule

START day- Monday, September 12th, 2022

Thanksgiving break- Monday, October 10th off

Fall Break- November 7th- November 11th

Christmas Break begins- Monday, December, 12th - Sunday, January 8th

Spring Break- February 20th- February 24th

Easter Break- April 10th - April 14th

Victoria Day- Monday, May 22nd off

LAST day- Friday, June 9th

Child's Information

First Name*

Middle

Last Name*

Preferred Name (nickname):

Street Address Line 1*

Street Address Line 2

City*

Prov.*

Postal Code*

Date of Birth*

Date

FemaleMale

Parent/Guardian Information

Parent/Guardian 1

Parent/Guardian Name*

Phone Number*

Area CodePhone Number

Relationship to Child*

Email Address*

Place of Work/Employer*

Street Address (if different than above)

City

Prov.

Postal Code

Parent/Guardian 2

Parent/Guardian Name

Phone Number

Area CodePhone Number

Relationship to Child

Email Address

example@example.com

Place of Work/Employer

Street Address (if different than above)

City

Prov.

Postal Code

Both parentsOne parentGuardian(s)Other

Please list names and ages of other siblings (if applicable):

Class Choices 9:15 a.m. - 11:30 or 12:30 p.m. - 2:45

Additional Comments or Questions regarding programming.

Options available for 2 day/week 3 year old programming- contact Lori @ 780.808.0959 for more information.

*Minimum of 7 children/playschool class required to operate a class.

$100.00 deposit due at registration to guarantee child's placement in the 1 day program.

$200.00 deposit due for 2 day program. $300.00 deposit due for 3 day program.

$50.00 Administration fee CHARGED on all refunds before July 1, 2022

Deposit payments accepted by: Cash, eTransfer, or Cheque payable to GUC Playschool.

ETRANSFER- gucplayschool@gmail.com

How will you be paying for the Deposit to secure your registration?

Deposit to secure playschool spot - $100.00 Due on registrationRemainder Payment ($700.00) Payment due the beginning of SeptemberSemester Payment ($350.00 X 2) Payments due the beginning of September and FebruaryMonthly payment ($70.00 X 10) Payments due the beginning of every month - Sept. - June

Deposit to secure playschool spot - $200.00 Due on registrationRemainder Payment ($1400) Payment due the beginning of SeptemberSemester Payment ($700.00 X 2) Payments due the beginning of September and FebruaryMonthly payment ($140.00 X 10) Payments due the beginning of every month - Sept. - June

Deposit to secure playschool spot - $300.00 Due on registrationRemainder Payment ($1800.00) Payment due the beginning of SeptemberSemester Payment ($900.00 X 2) Payments due the beginning of September and FebruaryMonthly Payment ($180.00 X 10) Payments due the beginning of every month - Sept. - June

How will you pay for the Playschool program throughout the year?

Emergency Contact #1 Other than Parent

First Name*

Last Name*

Relationship to Child*

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary Phone Number*

Area CodePhone Number

Secondary Phone Number

Area CodePhone Number

Emergency Contact #2 Other than Parent

First Name*

Last Name*

Relationship to Child*

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary Phone Number*

Area CodePhone Number

Secondary Phone Number

Area CodePhone Number

Indivduals OTHER THAN PARENT /Guardians authorized to pick up child from playschool:

Individual #1

First name*

Last name*

Relationship to Child*

Individual #2

First name*

Last name*

Relationship to Child*

Please inform instructor if someone who is not listed above will be picking up your child.

What are 3 words that describe your child?

1:*

2:*

3:*

What are 3 things that you hope your child will get out of playschool?

1:*

2:*

3:*

Is there anything we should know about your child's development? If there are concerns, is your child seeing anyone in regard to these concerns?*

Do you have any custody arrangements that the church should be made aware of?

Medical Information

Child's Health Care Number (AB/SK)*

Doctor Name*

Clinic Name*

Phone Number*

Immunizations up to date

Is your child on any regular medication? If yes, please list the medications and what they are used for. *

Please list any of the following: medication allergies, food allergies, or chronic health concerns.

Please inform the office/instructor of any other vital information he/she may need to know in the event of an emergency.

In the event of an emergency, such as sudden illness or accident, the GUC Playschool Society personnel has permission to call an ambulance or doctor. I understand any financial obligations resulting from this will be my responsibility.

Signature*

The GUC Playschool Society personnel has permission to take my child's photograph. I understand that photos taken at school may be posted in the school, used for crafts, used in the media (newspaper) and/or on social media (Facebook/website).

Signature*

The GUC Playschool Society personnel has permission to take my child to activities off the premises of the Grace United Church. I understand these off the premises activities will be communicated to me via monthly newsletters or face to face communication and will include field trips and outside park play.

Today's Date*

Signature

GUC Playschool Registration 2022-2023