WHCC July 2024- June 2025 Registration Form

Registration Form

July 2024 - June 2025
Child's Name*

First NameLast Name
Child's Date of Birth*

YearMonthDay
Parent/Guardian Name*

First NameLast Name
Email*
example@example.com
Phone Number*

My child will:*

be between 12 months and 19 months at my preferred start datebe over 20 months old and will not be in school at my preferred start dateattend Kindergarten in September 2024attend Grade 1 in September 2024attend Grade 2 to 6 in September 2024

Infant Care

12 to 19 months
My preferred schedule for the Summer Program (July 2 to August 30) is:*

5 days per week 730am to 5pm3 days per week 730am to 5pm (no Mondays)I do not require summer programming

Infant Care

My preferred 3 day schedule for the Summer Program (July 2 to August 30) is:
Choose 3 days*

TuesWedThurFri

I do not require summer care, please:*

Process and confirm space availability for the School Year Program asap; I will pay the $150 hold fee for the summer which will be withdrawn from my bank account on July 1, 2024.Process and confirm space availability for the School Year Program on July 15, 2024. I understand children attending the summer program or those paying the summer hold fee will have priority registration.

My preferred schedule for the School Year Program (September 3 to June 27) is:*

5 days per week 730am to 5pm3 days per week 730am to 5pm (no Mondays)

Infant Care

My preferred 3 day schedule for the School Year Program (September 3 to June 27) is:
Choose 3 days*

TuesWedThurFri

Toddler and PreK Care

20 months and older and not attending school
My preferred schedule for the Summer Program (July 2 to August 30) is:*

5 days per week 730am to 5pm3 days per week 730am to 5pm (no Mondays)I do not require summer care

Toddler and PreK Care

My preferred 3 day schedule for the Summer Program (July 2 to August 30) is:
Choose 3 days*

TuesWedThurFri

Toddler and PreK Care
I do not require summer care, please:*

Process and confirm space availability for the School Year Program asap; I will pay the $150 hold fee for the summer which will be withdrawn from my bank account on July 1, 2024.Process and confirm space availability for the School Year Program on July 15, 2024. I understand children attending the summer program or those paying the summer hold fee will have priority registration.

Toddler and PreK Care
My preferred schedule for the School Year Program (September 3 to June 27) is:*

5 days per week 730am to 5pm3 days per week 730am to 5pm (no Mondays)2 days per week 830am to 330pmI do not require school year programming

Toddler and PreK Care

My preferred 3 day schedule for the School Year Program (September 3 to June 27) is
Choose 3 days*

TuesWedThurFri

Toddler and PreK Care
My preferred 2 day schedule for the School Year Program (September 3 to June 27) is*

PreK - Kinder Care

Children attending Kindergarten in September 2024 are considered PreK in the summer program.
My preferred schedule for the Summer Program (July 2 to August 30) is:*

5 days per week 730am to 5pm3 days per week 730am to 5pm (no Mondays)I do not require summer programming

PreK - Kinder Care

My preferred 3 day schedule for the Summer Program (July 2 to August 30) is
Choose 3 days*

TuesWedThurFri

PreK - Kinder Care
I do not require summer care, please:*

Process and confirm space availability for the School Year Program asap; I will pay the $150 hold fee for the summer which will be withdrawn from my bank account on July 1, 2024.Process and confirm space availability for the School Year Program on July 15, 2024. I understand children attending the summer program or those paying the summer hold fee will have priority registration.

Kinder Care

Transportation support for children attending kindergarten is limited to Donnan School.
My preferred schedule for the School Year Program (September 3 to June 27) is:*

5 days per weekI do not require school year programming
My child attends school at:

DonnanOther, I will transport my child to school, and from school to WHCC

Kinder - Out of School Care (OSC)

Children who will be in Grade 1 in September 2024 are in Kindercare in the summer program.
My preferred schedule for the Summer Program (July 2 to August 30) is:*

5 days per week 730am to 5pmI do not require summer programming**

I do not require summer care, please:*

Process and confirm space availability for the School Year Program asap; I will pay the $150 hold fee for the summer which will be withdrawn from my bank account on July 1, 2024.Process and confirm space availability for the School Year Program on July 15, 2024. I understand children attending the summer program or those paying the summer hold fee will have priority registration.

Out of School Care (OSC)

Children who will be in Grade 2 to 6 in September 2024
My preferred schedule for the Summer Program (July 2 to August 30) is:*

Weekly campsI do not require summer programming

	My preferred weeks are:
July 2 - 5 (4 days)
July 8 - 12
July 15 - 19
July 22 - 26
July 29 - Aug 2
August 6 - 9 (4 days)
August 12 - 16
August 19 - 23
August 26 - 30 (school start up)

I do not require summer care, please:*

Process and confirm space availability for the School Year Program asap; I will pay the $150 hold fee for the summer which will be withdrawn from my bank account on July 1, 2024.Process and confirm space availability for the School Year Program on July 15, 2024. I understand children attending the summer program or those paying the summer hold fee will have priority registration.

My preferred schedule for the School Year Program (September 3 to June 27) is:*

5 days BEFORE and AFTER school5 days AFTER school onlyThursday Club 230pm to 5pmI do not require care

Parent/Guardian Agreement

Documentation Agreement

The nature of the philosophy at WHCC requires that staff participate in observing and documenting your Child's play and development. This includes the use of digital photography, video, and audio recording, as well as more traditional observational records and Nipissing Development Screens. These images, recordings and screens are used for several purposes.

Use of Storypark Profile

Parent Handbook

PAD Agreement and Banking Information
These services are for Personal use only. I, the payor, may revoke this authorization at any time, subject to providing 30 days notice. I have certain recourse rights if any debits do not comply with this agreement. For example, I have the right to receive reimbursement for any PAD that is not authorized or is not consistent with this PAD agreement. To obtain a form for a Reimbursement Claim, or for more information on my recourse rights, contact your financial institution or visit www.cdnpay.ca.
Pre-Authorized Debit (PAD) Agreement for Monthly Fees*
Pre-Authorized Debit (PAD) Agreement for Casino Deposit*
Banking Information*

Use the bank information on fileUse attached banking information

Upload a copy of your "Void" cheque

Cancelof
Take a photo of your "Void" cheque

Wild Heart Children's Centre is overseen by a Board of Directors made up of parent volunteers. The role of the Board is to act as the Governing body of the society, providing strategic direction and ensuring all the requirements of the society are fulfilled. If you are interested in participating on the board, we'd love to hear from you.*

I'm interested in serving! Tell me moreNo thanks
Is there anything else you would like us to know?

I, the undersigned, agree to all of the above terms and conditions.*

Clear
Today's Date*

MonthDayYear
Date

Ensure you click "Submit" once you preview your responses.

Please verify that you are human*
Should be Empty:

Registration Form

Infant Care

Infant Care

Infant Care

Toddler and PreK Care

Toddler and PreK Care

Toddler and PreK Care

Toddler and PreK Care

Toddler and PreK Care

Toddler and PreK Care

PreK - Kinder Care

PreK - Kinder Care

PreK - Kinder Care

Kinder Care

Kinder - Out of School Care (OSC)

Out of School Care (OSC)

Parent/Guardian Agreement

Documentation Agreement

Use of Storypark Profile

Parent Handbook

PAD Agreement and Banking Information