Genesis Preschool Registration Form

Registration

Genesis Christian Preschool Program
2024-2025
For information on hours and student fees for both our High River and Okotoks 3/4-year-old program, please visit our website.
At which Genesis Preschool location are you enrolling your child(ren)?*
Please indicate whether your family is:*

NEW to BrantRETURNING to Brant
How did you hear about Genesis Christian Preschool?
Parent/Guardian Information
1st Parent/Guardian Name*

First NameLast Name
Mailing Address*

Mailing Address

Address Line 2

CityState / Province

Postal / Zip Code or N/A
Is your 911 address different from your mailing address?*

NoYes
911 Address if different than mailing*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone*

Area CodePhone Number
Home Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
E-mail*
example@example.com
2nd Parent/Guardian Name

First NameLast Name
Address is the same as listed above
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
911 Address if different than mailing

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone

Area CodePhone Number
Home Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
E-mail
example@example.com
How many children are you registering for Genesis Preschool, 2024-25?*
If you wish to enroll more than 4 students, please complete this application for the first four and complete an additional application as necessary.

Information for Child #1
Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender:*
Age on Sept. 1, 2024*
Information for Child #2
Child 2*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender:*
Age on Sept. 1, 2024*
Information for Child #3
Child 3*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender:*
Age on Sept. 1, 2024*
Information for Child #4
Child 4*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender:*
Age on Sept. 1, 2024*

Genesis Preschool - Parent Consent/Contract Form High River
I agree that my child/children will be left in the Genesis Christian Preschool (High River) program on the following days and times:*

3/4 Year Old AM: Tuesday & Thursday 8:30 am to 11:30 am for a total of 6 hours per week. Child must be 3 by Sept. 1, 2024 or 4 by Dec. 31, 2024.3/4 Year Old PM: Tuesday & Thursday 12:30 pm to 3:30 pm for a total of 6 hours per week. Child must be 3 by Sept. 1, 2024 or 4 by Dec. 31, 2024.
 Parents agree to pay a fee of $150.00 per month for the above scheduled hours of childcare promptly in accordance with the program policy. The Program reserves the right to exclude the child(ren) from the program if fees are in arrears.

 Throughout the year there may be reason to take photographs of your child for the purposes of class memories, school photo albums or bulletin board displays. I hereby grant the staff of Genesis Preschool permission to photograph my child(ren) to be used for the mentioned purposes. I recognize that separate permission letters may be requested during the year for use of photographs related to promotional or advertising purposes. I also recognize that photographs may be taken by the local print & broadcast media as a means of promoting and reporting on preschool activities where students may or may not be identified by name or face.

 I have read and understand the snack requirements and appropriate foods that will be served by the preschool and prepared by the parents, adhering to the health department and social services licensing requirements for group care.

 I hereby understand and agree to comply with the policies and procedures of Genesis Preschool.

 Removal of my child from the program requires one month written notice, directed to the teacher.

 I understand that Genesis Preschool does not accept withdrawals from the program after April 1st. Anyone who does remove their child after this date does so without refund. If you want to remove your child from the program starting April 1st, we must receive notice by March 1st.

 I understand Genesis Preschool reserves the right to release my child from the program if there is failure to comply with the policies of the preschool or failure to make monthly payments on time or a discipline problem that cannot be resolved.

 We occasionally go outdoors during good weather for a neighbourhood walk or park activity. I acknowledge I have signed the walking permission form.

 In the event of an emergency I authorize staff of Genesis Preschool to give my child emergency care. This may involve calling an ambulance at parent's/guardian's expense.

 I do not in any way hold Genesis Preschool or its staff responsible for any accidents or injury to my child or their property or clothing.
Parent/Guardian*

Clear
By signing this registration form you are consenting to the use and disclosure of the personal information provided to the Brant Christian School Society for internal purposes only.

Genesis Preschool - Parent Consent/Contract Form Okotoks
I agree that my child/children may be left in the Genesis Christian Preschool program on the following days and times:*

3/4 Year Old AM: Monday & Wednesday 8:30 am to 11:30 am for a total of 6 hours per week. Child must be 3 by Sept. 1, 2024 or 4 by Dec. 31, 2024.3/4 Year Old PM: Monday & Wednesday 12:30 pm to 3:30 am for a total of 6 hours per week. Child must be 3 by Sept. 1, 2024 or 4 by Dec. 31, 2024.
 Parents agree to pay a fee of $175.00 per month for the above scheduled hours of childcare promptly in accordance with the program policy. The Program reserves the right to exclude the child(ren) from the program if fees are in arrears.

 Throughout the year there may be reason to take photographs of your child for the purposes of class memories, school photo albums or bulletin board displays. I hereby grant the staff of Genesis Preschool permission to photograph my child(ren) to be used for the mentioned purposes. I recognize that separate permission letters may be requested during the year for use of photographs related to promotional or advertising purposes. I also recognize that photographs may be taken by the local print & broadcast media as a means of promoting and reporting on preschool activities where students may or may not be identified by name or face.

 I have read and understand the snack requirements and appropriate foods that will be served by the preschool and prepared by the parents, adhering to the health department and social services licensing requirements for group care.

 I hereby understand and agree to comply with the policies and procedures of Genesis Preschool.

 Removal of my child from the program requires one month written notice, directed to the teacher.

 I understand that Genesis Preschool does not accept withdrawals from the program after April 1st. Anyone who does remove their child after this date does so without refund. If you want to remove your child from the program starting April 1st, we must receive notice by March 1st.

 I understand Genesis Preschool reserves the right to release my child from the program if there is failure to comply with the policies of the preschool or failure to make monthly payments on time or a discipline problem that cannot be resolved.

 We occasionally go outdoors during good weather for a neighbourhood walk or park activity. I acknowledge I have signed the walking permission form.

 In the event of an emergency I authorize staff of Genesis Preschool to give my child emergency care. This may involve calling an ambulance at parent's/guardian's expense.

 I do not in any way hold Genesis Preschool or its staff responsible for any accidents or injury to my child or their property or clothing.
Signature*

Clear
By signing this registration form you are consenting to the use and disclosure of the personal information provided to the Brant Christian School Society for internal purposes only.

Payments

Your first payment is required to submit this form. This payment must be made by credit card, using the form at the bottom of this page. First payment is calculated as follows:
- New families: $45 + 1 month's preschool fees
- Returning families: $35 + 1 month's preschool fees
Before making your initial payment, please indicate how you plan to make subsequent payments. These payments can be made monthly using either your credit card or automated bank account debit. Subsequent payments are calculated as follows:
- Okotoks: $175/month/child
- High River: $150/month/child
If you select Bank Account Auto Debit, please follow the link below and fill out the PAD form. If you select Credit Card Auto Payment, you will receive further instructions in September about completing that process.
How will your subsequent monthly payments be processed?*

Credit Card Auto PaymentBank Account Auto Debit
Automated Bank Account Debit (Pre-Authorized Debit)

If you would like to pay your subsequent fees via automatic bank account withdrawals, please click the link below and fill out the form:

Automatic withdrawal (PAD)
Credit Card Payments

After you submit this form, please visit our website (www.brantchristianschool.ca/genesis-christian-preschool - click now to open in a new tab), where you'll find links to our One-Time Credit Card Payment and Monthly Credit Card Payments forms.
Calculation - initial payment
Calculation - monthly fee

Initial Payment*

CAD1 x $35 or $45 (new families) non-refundable application fee + one month preschool fee(s)

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Registration

Parent/Guardian Information

Information for Child #1

Information for Child #2

Information for Child #3

Information for Child #4

Emergency Contact/Authorized Release #1 (other than parent)

Emergency Contact/Authorized Release #2 (other than parent)

Person(s) to Whom Child(ren) May Not Be Released

Special Needs/Disabilities

Allergies

Immunizations

Preschool Handbook