Dalhousie Community Kindergarten Registration Form: Kindergarten/Junior Kindergarten Students

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This registration form is a legal document and must be completed by the student's parent or legal guardian.

The personal information collected on this form is collected under the authority of Alberta's Freedom of Information and Protection of Privacy (FOIP) Act and its regulations.

This information will be used for the establishment and maintenance of the student's record, as per our obligations under the Education Act of Alberta.
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Child's Legal Name* This field is required.(As it appears on birth certificate or passport, etc.)
First Name
Middle Name
Last Name
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Child's preferred name (if different from above):
preferred name if different from above
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Child's Date of Birth:* This field is required.yyy-mm-dd
Date
Year
Month
Day
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Gender:* This field is required.
Female
Male
Another
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Student Mailing Address* This field is required.Please provide the address of the parent/legal guardian where the student lives full time. If the student lives with more than one legal guardian that do not live together, the legal guardians must choose one address to use as the student's primary residence.
Street Address
Street Address Line 2
City
Province
Postal Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Student's Country of Citizenship:* This field is required.(Copies of documentation will be required at a later date. This may include a copy of the student's birth certificate or passport for Canadian citizens)
Canadian
Other
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If not a Canadian Citizen, please provide additional details including Country of Citizenship and type of document to be provided regarding citizenship. (i.e. Permanent Resident, Temporary Resident, Refugee Claimant, Child of Canadian Citizen, Child of lawfully admitted permanent or temporary resident, or other)
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Student Home Phone Number* This field is required.
Area Code
Phone Number
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Parent/Guardian #1 Contact Info: (provide all that may be applicable. Must provide an email address as well as one phone number)
First Name *     Last Name *

Email: Email *
Home: Area Code     Phone Number
Work:    Area Code     Phone Number
Cell:    Area Code     Phone Number

Lives with student?      Yes     No
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Parent/Guardian #2 Contact Info: (provide all that may be applicable. Must provide an email address as well as one phone number)
First Name *     Last Name *

Email: Email
Home: Area Code     Phone Number
Work:    Area Code     Phone Number
Cell:    Area Code     Phone Number

Lives with student?      Yes     No
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Provide an email address below if you would you like to designate a single primary Parent/Guardian email address to be used for general school related email correspondence.(This is optional. Both parents/guardians can receive general school related emails. If an email address is provided here, this will be the only email address used for emails relating to things like newsletters, announcements, etc. Please note: our teacher uses a separate communication app for classroom related reminders and notices and parents will have a separate opportunity to join that communication list.
example@example.com
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Student Medical Conditions or Allergies: Does the student have any of the following:* This field is required.(If you answer yes to either of these questions, you will be asked for more details)
YesNo
YesNo
Life threatening medical condition or allergy
Non life threatening medical condition or allergy
Life threatening medical condition or allergy
YesNo
YesNo
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Please provide a brief description of any noted medical/allergy concerns
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Languages spoken at home:(Please list)
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Has your child attended preschool previously? If yes, please tell us the name or location of their previous program:* This field is required.
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Has your child been assessed for, or is scheduled to be assessed for, or received support services such as Speech Language Therapy (SLP), Occupational Therapy (OT), Program Unit Funding (PUF), Psychological/Behavioural support or other any other mild/moderate coded services?* This field is required.
YESNO
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Please provide brief details:* This field is required.
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Name of your contact or agency/service provider?(You can provide additional relevant information if you desire )
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Do you give us permission to contact your agency/service provider?
YESNO
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Name of person to contact as well as email address and/or telephone number (if available
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Additional comments you may like to provide related to your student or your registration:
Huge
Large
Normal
Small
Ok
Ok
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We will be providing a morning class that operates Monday to Friday (tentative class hours 8:45 am to 11:35 am), and if we have sufficient registrations, an afternoon class that operates Monday to Thursday (tentative class hours 12:20 pm to 3:25 pm). Please check class option preferences that apply to you:
Strongly prefer the M-F morning class
Strongly prefer the M-R afternoon class
Either class option works for us
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Will you possibly need the services of the Before and After School Care program that is operated in our building by the Dalhousie Community Association?* This field is required.The Before and After School Care program is a licensed and accredited childcare program for children who will be 5 by December 31 of the current school year. Parents can choose from full time, part time and drop-in options. The program provides child care on instructional days (between 7am and 6pm) and most non-instructional days. A separate registration process (which typically takes place in May) is required for this program. Visit the program page of www.dalhousiecalgary.ca for more information.
YESNO
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Please tell us how you heard about our program:* This field is required.(Select as many that apply)
Posters/signs
Previous experience or interaction
Recommendation from other
Dalhousie Digest
Facebook
Instagram
Banner over roadway
Internet Search (i.e Google, etc)
Other Social Media
Other
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You are almost finished! Please read and check EACH of the following: * This field is required.(Payment of fees referenced below can be made via etransfer to info@dcakids.com, or by cheque. No password is required for etransfers - they will be automatically deposited. Cheques should be made out to Dalhousie Community Kindergarten and left at the front desk at the Dalhousie Community Association at 5432 Dalhart Rd NW. Please contact us if you would further clarification.)
YES
I understand that submission of a form does not guarantee enrolment in the program, however registration applications are assigned a spot in sequential order according to when my email is sent to request registration.
Row 0, Column 0
I understand that to complete the registration process and hold my spot, I must pay a $75 registration fee. My spot will only be held until the end of the day that this form is submitted. If my fee is not paid by the end of the day, my spot will be re-assigned to the following day, until the fee is paid.
Row 1, Column 0
I understand that the registration fee will be refunded if a spot in the program is not offered to my child.
Row 2, Column 0
I understand that a separate "Confirmation of Enrolment" (confirming that a spot has been offered to my child) will be sent directly from the program's administrator.
Row 3, Column 0
I understand that a one-time Program Fee of $120 must be paid by May 31 for all children who are enrolled in the program. Once paid, this program fee is only refundable if you withdraw your registration prior to June 30.
Row 4, Column 0
To the best of my knowledge, the information provided in this form is accurate and complete, and I have the authority to register the student identified on this form. I will notify the school immediately of any changes to the information on this form.
Row 5, Column 0
I understand that submission of a form does not guarantee enrolment in the program, however registration applications are assigned a spot in sequential order according to when my email is sent to request registration.
I understand that to complete the registration process and hold my spot, I must pay a $75 registration fee. My spot will only be held until the end of the day that this form is submitted. If my fee is not paid by the end of the day, my spot will be re-assigned to the following day, until the fee is paid.
I understand that the registration fee will be refunded if a spot in the program is not offered to my child.
I understand that a separate "Confirmation of Enrolment" (confirming that a spot has been offered to my child) will be sent directly from the program's administrator.
I understand that a one-time Program Fee of $120 must be paid by May 31 for all children who are enrolled in the program. Once paid, this program fee is only refundable if you withdraw your registration prior to June 30.
To the best of my knowledge, the information provided in this form is accurate and complete, and I have the authority to register the student identified on this form. I will notify the school immediately of any changes to the information on this form.
YES
Row 0, Column 0
YES
Row 1, Column 0
YES
Row 2, Column 0
YES
Row 3, Column 0
YES
Row 4, Column 0
YES
Row 5, Column 0
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Please verify that you are human* This field is required.
Should be Empty: