Sensory Session Registration Form

2023 Sensory Session Registration Form

For Saturday Sessions & Pop-Up Sensory Playdates
Welcome!

We're so excited to have you on board for our sensory sessions and cannot wait to share all the exciting things we have planned. Please fill out the information below. Once completed, it does not need to be filled out again if your child attends further sessions unless your child's information has changed and needs to be updated.
The first day that my child will join a session will be… *

MonthDayYear
Date
Child's Information

All about your little one!
Child's Name*

First NameLast Name
Age*
Gender*
Date of Birth*

MonthDayYear
Date
Child's Photo (Optional)

Browse Files

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Is your child on the autism spectrum or do they have any special needs/disabilities? We ask because sometimes it is more helpful to the child if they come to sessions with their shadow or nanny as it is an environment with many things that will be new to them (new space, children, team, experience etc.).*

YesNoPossibly
If yes, please let us know which. If possible, please provide us with any relevant information.
You can skip this if you had chosen NO.
Medical Information

Please skip this section if none are applicable to your child.
Does your child have any allergies? If yes, please list them below:
Does your child have any current medical conditions? If yes, please list them below:
Does your child takes any medication? If yes, please list them below and explain its purpose:
Parent/Guardian's Information

Incase we need to get in touch with you!
Parent 1's Name*

First NameLast Name
Parent 1's Phone Number*

Area CodePhone Number
Parent 1's Email*
example@example.com
Parent 2's Name

First NameLast Name
Parent 2's Phone Number

Area CodePhone Number
Parent 2's Email
example@example.com
Authorized person(s) to pick up your child: *
Emergency Contact (EC)

Incase we can't get in touch with you!
EC's Name*

First NameLast Name
EC's Relation*
EC's Phone Number*

Area CodePhone Number
Payment Details

The Hands-On option below is ONLY for parents of children who have special needs or require one-on-one assistance from one of our special aunties. Payments should be done via bank transfer. A screenshot of the payment can be sent to sensorysetsja@gmail.com. After, a receipt will be sent to you. Payments can be made to: Myelle Peralto || NCB Constant Spring || Savings account #334463664
Payment
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Weekly Saturday Session3,500.00JMD
Register for one session only

Four Week Saturday Sessions13,000.00JMD
Register for 4 weeks (weeks are subject to change based on holidays etc. - if a Saturday is not in session parents will be allowed to let the week roll over onto another.)

Weekly Saturday Sessions + Hands-On5,500.00JMD
Register for one session only + a hands-on auntie to work with your child (this is applicable to children who have special needs/disabilities, and/or are on the autism spectrum OR children under 2 for their first two sessions).

Four Week Saturday Sessions + Hands-On21,000.00JMD
Register for 4 weeks + a hands-on auntie to work with your child. (weeks are subject to change based on holidays etc. - if a Saturday is not in session parents will be allowed to let the week roll over onto another.) This is applicable to children who have special needs/disabilities, and/or are on the autism spectrum.

Total 0.00JMD
Authorization
I, the parent/guardian of this child understand that the organizers and/or staff will have made every effort to keep my child safe and involved during their session. I understand that I am not contracting with Rainbow Land and that the Saturday sessions are not a program run by Rainbow Land. I give authority to the staff of this Saturday series to apply judgement in regards to medical assistance in the event of an accident, injury, or illness IF the parent/guardian or emergency contact person(s) cannot be reached. I authorize any first aid and treatment which may be deemed necessary. I release Rainbow Land Nursery & Pre-K and the staff of the Saturday series of responsibility in case of accident, illness, or injury during my child's enrollment. I confirm that all information given in this form is true, complete, and accurate.
Parent/Guardian's Signature
Date

MonthDayYear
Date
COVID-19 Agreement

This agreement is subject to change based on the COVID-19 regulations of both Rainbow Land Nursery School and the government mandates.
▪ Each child, parent, and staff member on the premises have the option of wearing or not wearing a mask. Parents who would prefer to have their children wear a mask will inform us prior to the sensory session so that we may make every effort to encourage the child to do so. These children should wear a mask upon entry (with a mask lanyard) to Rainbow Land and carry an extra mask in a sealed bag or Ziploc bag just incase.

▪ Upon arrival, parents and children must wash their hands at the hand washing station. After, the child’s temperature will be taken by the staff member at the entrance of Rainbow Land. If their temperature is normal, the sanitization of feet and bags will be done via a spray.
▪ If a child or parent shows any signs of a cold or fever, they will not be permitted to enter.
▪ Physical distancing should be observed on all areas of the property.

▪ At drop-off time a parent/guardian can walk his/her child to the entrance to say goodbye as we know that the separation process is at times difficult for some children and for some parents too. We are hoping that once the Covid circumstances are different, we can have a more open-door policy when it comes to sessions but at this time only the children and the team are permitted to be inside the space. Parents will be kindly asked not to gather in groups outside for social purposes at drop off or pick-up times.

▪ Parents will not be allowed inside of the school (indoors) at any time.
▪ If a child becomes sick, the child will be gently removed from the space and a parent/guardian will be called to pick up the sick child immediately.

▪ If a child or parent has contracted Covid-19 within 5 days after a session, we will need to be notified so that we can make our necessary checks.

I agree to the terms stated above regarding COVID-19 regulations at this time.
Parent/Guardian's Signature
Date

MonthDayYear
Date
Should be Empty:

2023 Sensory Session Registration Form

Welcome!

Child's Information

Medical Information

Parent/Guardian's Information

Emergency Contact (EC)

Payment Details

Authorization

COVID-19 Agreement