DMSD Registration Form

  • Durham Montessori School and Daycare

  • Registration Form

    e: info @dmsd.ca / 200 Byron St S, Whitby, ON, L1N 4 P6 / p: 905-665-0505

  • Student Information

  • Birth Date*
     - -
  • Start Date*
     - -
  • Have you been referred to Durham Montessori School and Daycare or has a family previously attended our school?*
  • Are you expecting?*

  • Parent/Guardian 1

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Parent/Guardian 2

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Parent/Guardian Residence Information (if different from above)

  • Emergency Contact 1

  •  -

  • Emergency Contact 2

  •  -

  • Authorization for Pickup

    Your child will only be released to an authorized person listed on this form (parent/guardian and/or emergency contact if notified by parent/guardian via phone or email). In case of an emergency or an unforeseen circumstance, please indicate the name, address and phone number of any other person/s who you authorize to pick up your child on your behalf.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • A parent/guardian's verbal or written authorization for pickup must be received by Durham Montessori School and Daycare Staff before your child will be released including to anyone listed here. If not received, and we cannot notify you by phone, the child will not be released. Please note that the person picking up must provide Photo Identification, Contact Information and be 18 years or older before child can be released.

  • Physician and Medical Information

  •  -

  • Immunization

    The Child Care and Early Years Act requires that we have a photocopy of your child's recent immunization record in our files. Please include a photocopy with this registration form. If you do not have the records, a copy can be obtained from your Doctor.
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  • Communicable Diseases

    (Check those that your child has had):
  • *

  • Drop Off And Pick-Up Times

  • We expect full participation from your child in all aspects of the program to the best of their ability. This includes involvement in program-based activities, both indoor and outdoor gross motor activities, as well as rest time. If your child is unable to participate due to illness, we kindly require that you keep them at home for 24 hours symptom free before returning to program. I acknowledge and agree with the above statement, and I commit to keeping my child at home when they are unwell. I understand that I must arrange for their pickup within one hour if they become ill during the day. Furthermore, parents are required to provide one month's written notice if they wish to change the number of childcare days and is subject to availability. It is important to note that if my child is picked up during the day for any reason including appointments, they are not permitted to return to the program for the remainder of that day.
  • Date*
     - -

  • Signature of Director/Supervisor:

  • Date:

  • Parent Consent Form

  • FIELD TRIPS/VISITORS

  • I hereby give consent for my child to participate in excursions, within walking distance of the school, under the guidance of the staff of Durham Montessori School and Daycare.*

  • I understand monthly visitors/trips are apart of the program. If I do not wish for my child to participate, I will still be required to pay for the program fees for that day and will not bring my child to school until 12pm, or when normal programming resumes for that day should programming resume later than 12pm.

  • Medical Attention

  • In the event of an emergency, I understand and agree that my son/daughter, will receive:*
  • I understand further that I will be informed of the situation as soon as possible and that initial contact will be attempted by calling the telephone number(s) noted in the registration form.*
  • Date*
     - -

  • Videotape/Photo Consent Form

    From time to time, staff will videotape or photograph the children at Durham Montessori School and Daycare. Both the photos and videos are useful for staff training, community and education awareness purposes. Occasionally, they may appear in the newspapers, our website, Facebook and/or Instagram. Please select ONE of the following choices.
  • *
  • Date*
     - -

  • Background Information

  • EMERGENCY CLASSROOM RECORD

  • Date of Birth:*
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Emergency Contacts (If different from above)

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • PROGRAM DAILY FEES

  • Monthly tuition fees are payable to Durham Montessori School and Daycare before the 1st of every month. If the 1st falls on a weekend, holiday, or school closure, the childcare payment is required by the Friday before. There is a late fee charge of $5.00 per day effective on the 1st day of every month. If the fees are not submitted by the 2nd day of the month, a letter will be issued which states childcare services will be terminated immediately. Childcare fees are subject to increase and policies may change before the child's start date. Durham Montessori School and Care will be accepting payments by E-Transfer, cash, money order, certified cheque, and preauthorized payments. If a parent is late to pick up their child at the school's closing time, a late pick-up fee of $2 per minute applies. An invoice will be sent, and an E-Transfer is to be made within 24 hours. Our program fee will not change while child is registered at Durham Montessori School and Daycare until the following September regardless of age or classroom change.

  • REGISTRATION FEE: $500.00 (per child)

  • DEPOSIT FEE: $500.00 (per child)

  • Parents are required to provide two (2) months written notice of withdrawal during business hours. Failure to provide adequate notice will result in the forfeiture of the deposit paid at the time of registration. Deposits will only be applied to the last month's childcare invoice. Your child's spot is reserved for 1 year from the start date, otherwise, the deposit fee will not be refunded unless amended by the director at registration. The deposit is NON-REFUNDABLE even if parents decide to withdraw their child before the agreed start date on the registration form or the first month with Durham Montessori School and Dare. Parents are required to pay daily program fees for all Statutory Holidays, Winter Break, March Break, Summer Break, and sudden interruption of classroom or other school closures.

  • I have read and understand Durham Montessori School and Daycare's payment requirements and agree to accept all the school's policies and any additional information or policies added annually in Durham Montessori School and Daycare's Parent Handbook made available to me to print on their website (www.dmsd.ca).
  • Date:*
     - -

  • Signature of Director/Supervisor:

  • Date:

  • Blanket Form For All Products Administered By Durham Montessori School and Daycare Staff

    Durham Montessori School and Daycare staff are hereby authorized to administer sunscreen, diaper rash cream, insect repellent, lip balm, body moisturizers and/or other products supplied by their parents/guardians daily or whenever needed.
  • Date*
     - -

  • Our Programs

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                  Toddler Casa (12-18 months)

                  Full Time (Daily Fee)

                  $82 CAD$82CAD
                    
                  Toddler Casa (19-36 months)

                  Full Time (Daily Fee)

                  $73 CAD$73CAD
                    
                  Toddler Casa (19-36 months)

                  Part Time (Daily Fee) (Mon, Wed, Fri)

                  $84 CAD$84CAD
                    
                  Toddler Casa (19-36 months)

                  Part Time (Daily Fee) (Tues, Thurs)

                  $89 CAD$89CAD
                    
                  Preschool Casa (3 years - 5.11 years)

                  Full Time (Daily Fee)

                  $71 CAD$71CAD
                    
                  Preschool Casa (3 years - 5.11 years)

                  Part Time (Daily Fee) (Mon, Wed, Fri)

                  $84 CAD$84CAD
                    
                  Preschool Casa (3 years to 5.11 years)

                  Part Time (Daily Fee) (Tue, Thurs)

                  $89 CAD$89CAD
                    
                  Total
                  $0.00 CAD$0.00CAD

                • *ADMIN USE ONLY*

                • Room Registered:

                • Full-Time/Part-Time Registered:

                • Start Date:

                • End Date:

                • Registration Received:

                • Deposit Received:

                • Deposit Returned:

                • Immunization Received:

                • Should be Empty: