Summer 2023 Preschool Registration Form

Small But Mighty Preschool Summer Camp Registration Form

July 2023
** Our summer camps are now full - please complete a registration form if you are interested in being added to our waitlist**

Program Details

We can't wait to celebrate the summer with you! Camps will run Monday through Friday from 9am-12pm over the weeks of July 17th and 31st. Available for children ages 3-6 😊
Summer Camp Selection
Please select the program/s in which you wish to enroll your child.

July 17th - 21st: Exploring Nature - How Things Grow!July 31st - August 4th: Summer Scientists!
Student Information
First Name*
Last Name*
Gender*

FemaleMale
Birth Date*

MonthDayYear
Home Phone*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Alberta Health Care Number*
Child's Primary Language
Languages Spoken at Home
Parent/Guardian Information 1
Full Name*

First NameLast Name
Home Telephone*

Area CodePhone Number
Cell Number*

Area CodePhone Number
Work Telephone

Area CodePhone Number
E-mail*
Relationship to the Child*
Address - Same As Child*

YesNo
If your address is different than your child's, please fill out the information below. Otherwise please skip to the next section.
Parent/Guardian 1 Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Guardian Information 2
Full Name

First NameLast Name
Home Telephone

Area CodePhone Number
Cell Number

Area CodePhone Number
Work Telephone

Area CodePhone Number
E-mail
Relationship to the Child
Address - Same As Child

YesNo
If your address is different than your child's, please fill out the information below. Otherwise please skip to the next section.
Parent/ Guardian 2 Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Local Emergency Contact

*Note: Your emergency contact must be someone other than the 1st and 2nd parents/ guardians listed above.
Full Name*

First NameLast Name
Relationship to the Child*
Home Telephone*

Area CodePhone Number
Cell Number*

Area CodePhone Number
Work Telephone

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Individuals Approved to Pick-Up Child (Other than 1st and 2nd Guardians)

*Note: Individuals will be required to show ID at time of pick-up
1) Full Name*

First NameLast Name
Phone Number*

Area CodePhone Number
2) Full Name

First NameLast Name
Phone Number

Area CodePhone Number
3) Full Name

First NameLast Name
Phone Number

Area CodePhone Number
Strengths and Need for Support
Child's Interests and Strengths: *
Child's Unique Needs for Support: *
Would you like to be contacted to discuss your child's needs prior to the start of camp?*

YesNo
Medical Information
Medical History/ Chronic Conditions: *
Current and Long-Term Medications: *
Does your child have any allergies?*

YesNo
If yes please list, including any food or drug allergies.*
Does your child require any medication that we should be aware of? If yes, please list these medications.*
Do you authorize us to administer any of the medications listed above? Please note a separate medical release form will be emailed to you upon registration if you select "yes."

YesNo
Are your child's immunizations up to date? This information is only used to contact families in the event of an outbreak.*

YesNo
Additional Comments or Concerns:
Enrolment Agreement and Payment
We kindly ask that parents/ guardians e-transfer their child's payment of $175 to: smallbutmightypreschool@gmail.com within 3 business days of registration. Thank you in advance!

We recognize that summer is a busy time for families! Refunds are available when notice is provided 3 weeks in advance to the start of your child's week at camp.

Please note that our camp is an extension of our licensed preschool program. Qualifying students are eligible to claim subsidy for a flat rate of $125 for the month of July. Please contact our staff with any questions you may have surrounding subsidy.
Toileting Policy
We understand that preschool age is a critical time for children in terms of learning toileting skills. We ask guardians to send children to camp with an extra set of clothing in case of accidents. Children may be sent in pull-ups or with multiple sets of clothing. Our teachers and staff are trained in assisting children who require help after having an accident and can offer support as children learn how to use the toilet independently. If you have concerns about your child and their overall toileting readiness, please do not hesitate to contact us at: smallbutmightypreschool@gmail.com
Sickness Policy
Government of Alberta regulation requires children with diarrhea, fever, vomiting, unexplained cough or rash, or any other symptoms associated with communicable diseases to be kept home until they are 24 - 48 hours symptom free. If a child becomes ill with the symptoms listed above, or displays any other symptoms that staff believes may pose a health risk to their peers, they are required to isolate the child. Isolation will occur in the safety of the staff office space, where they will remain accompanied at all times. Staff will also contact the guardian to inform them of their child’s symptoms and make arrangements for the child to be picked-up as soon as possible.

As camp is limited in duration, refunds are available upon request for students who are unable to attend due to illness. Notice must be given to camp staff 24 hours prior to the start of your child's week at camp to receive a refund.
Consent Agreement
I, Printed Full Name* , the parent/ guardian of Child's Name* , hereby give my approval and permission for:
Please select all that apply:*

My child to participate in Small But Mighty Preschool's Summer Camps
*

The staff to administer first aid to my child for an injury or illness that occurs while my child is present at camp. All staff members have up-to-date First Aid Child Care Training.
*

My child to be transported by ambulance to the nearest hospital in the case of an emergency/ injury. I authorize all medical and surgical treatments, such as x-ray or surgery, that are deemed necessary by paramedics or an attending physician. I understand and agree that in such a scenario, parents/ guardians are responsible for the cost of the ambulance. I further understand that all efforts will be made to contact parents/ guardians immediately and that this section of the waiver ONLY applies if parents/ guardians cannot be contacted in the case of an emergency.
My child to be included in any photographs, videos, social media, or print materials used to promote Small But Mighty Preschool and our Summer Camps
*

Finally, I release Small But Mighty Preschool - Summer Camps, its employees and its staff from liability to the above named student, arising from injury to the person or property of the above named child occurring on the premises of Small But Mighty Preschool, and or travel to and from such activities.
(Name of Parent/ Guardian) * , Dated this* day of 20 .
Signature*
All registrations are received and reviewed on a first come, first serve basis.

Thank you very much for your child's registration! We look forward to playing, learning, and celebrating summer together!
Should be Empty:

Small But Mighty Preschool Summer Camp Registration Form

Summer Camp Selection

Student Information

Parent/Guardian Information 1

Parent/Guardian Information 2

Enrolment Agreement and Payment

Toileting Policy

Sickness Policy

Consent Agreement