Kids' French School Registration Form

C) Medical Information
OHIP Card
Family Physician*

First NameLast Name
Address*

Street Address

CityProvince

Zip CodeCountry
Preferred Hospital
Insurance/Health Coverage (Company)
Has your child been fully immunized?*
Name of Health Unit*
Has your child been diagnosed with any disease? If so, please specify.
Has your child ever had any serious illness or accident? If so, please specify.
Has your child's vision been checked?
Are corrective lenses required?
Has your child's hearing been checked?
Does your child take a nap?*
Does your child sleep well?
Please elaborate further on the above if necessary.
Does your child have Epilepsy ?*
Does your child have severe allergies/anaphylaxis? Let us know if your child requires an epi-pen.*
Does your child have Asthma ? If yes, please make sure they bring their inhaler.*
Is your child taking or receiving any medication?*
If Yes, please provide more details and discuss this with our director.
Does your child have any known emotional or behavioural problems?*
If Yes, Please state in brief what and discuss this with our director.
Does your child follow a specific diet?*
If Yes, Please state in brief what and discuss this with our director.

Does your child have Canadian Citizenship?*
If not a Canadian Citizen, please specify type of visa and expiry date:
Child's Mother Tongue
Other language(s) spoken at home?
Please complete all fields to the best of your knowledge and inform the office of any other vital information we should be aware of in the event of an emergency. Thank you.
Parent / Guardian Signature*
Please bring this registration form along with the following documentation to our office or send by email. We are required by the Ontario Ministry of Education to keep copies of all documentation on file. Please supply all original documents, which we will photocopy.
For Office Use

Birth CertificateOHIP CardImmunization RecordsMedication documentation
Please note we charge a $250.00 registration fee for all new registrations.
Payment Methods

Cheque to Ma Classe French Learning Inc.E-Transfer to info@kidsfrenchschool.caCash
Should be Empty:

A) Student Information