WBCNS Child Registration Form 2024/2025

WBCNS Child Registration Form 2024/2025
Child Information
Child’s Name*

First NameLast Name
Preferred Name / Nickname
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemaleOther
Preferred Class - registrar will contact you with current availability*

A Day - Monday, Tuesday, WednesdayB Day - Thursday, Friday5 Days - 30 months+ onlyNo Preference
Email*
example@example.com
Home Phone Number*
Please enter a valid phone number.
Home Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Does your child require a resource teacher?*

YesNo
If yes, please specify:

Family Contact Information

Parent/Caregiver 1
Parent/Caregiver Name*

First NameLast Name
Primary Phone Number*
Please enter a valid phone number
Work Phone Number
Please enter a valid phone number
Work Address

Street Address

Street Address Line 2

CityProvince

Postal Code
Home Address (if different from child)

Street Address

Street Address Line 2

CityProvince

Postal Code
Parent/Caregiver 2
Parent/Caregiver Name

First NameLast Name
Primary Phone Number
Please enter a valid phone number
Work Phone Number
Please enter a valid phone number
Work Address

Street Address

Street Address Line 2

CityProvince

Postal Code
Home Address (if different from child)

Street Address

Street Address Line 2

CityProvince

Postal Code
Emergency Contacts / Authorized Pickups

Medical Information
Health Card Number*
Family Doctor Information
Does your child have any allergies?*

YesNo
If yes, please specify:
Has your child had any serious accidents, illnesses, injuries or long periods in the hospital? Give details including listing your child’s previous history of communicable diseases and conditions requiring medical attention.*

Social and Developmental History
Has either parent been away for a long period of time or permanently absent from the home?*

YesNo
For how long?
Effect on child
Siblings
Other than parents, who takes care of your child? How Frequently?
How many homes has your child lived in since birth?
Has your child had any group experience (Sunday School, Playgroups, etc.)?How frequently attended?
Does your child play independently? How often? *
Why are you sending your child to nursery school?*
Have you, your doctor, or any professional expressed concern regarding your child meeting any developmental or physical milestones?*
If there is anything you would prefer to discuss privately with your child’s teacher, please contact them for an appointment. Please add below any comments on any points that have not been covered and might further the teacher’s understanding of your child. *

WBCNS Parent Contract
The conditions of this agreement protect the parents, the children and the Wasaga Beach Co-operative Nursery School. It assures the school that you will financially support the space guaranteed for your child and licensing requirements will be met. Such guarantees from parents protect the financial and legal stability of the school and ensure it continues to provide a quality nursery school program for your child.
I, {parentcaregiverName} the parent/caregiver of {childsName}, agree to:
- Accept membership in the Wasaga Beach Co-Operative Nursery School Inc. Upon my child's enrolment and I agree to resign my membership upon my child's withdrawal.
- Pay the monthly fee via automatic withdrawal.
- The automatic withdrawal of a $90 bond payment should I fail to complete my duties as a member. I understand that the payment will be automatically processed for non-completion of my committee's duties; failure to attend mandatory meetings.
- Give the school 30 days' notice in writing when my child is being withdrawn.
- Fundraise a total of $50 per month enrolled in the program. I acknowledge that any difference at the end of the year, or upon withdrawal from the program of the amount committed to and the amount raised will be automatically processed via direct payment.
I, {parentcaregiverName}, the parent/caregiver of {childsName}, understand that:
- The monthly fees are set by the Board of Directors and reviewed annually. I am responsible to pay the full monthly fee.
- If my child is having difficulty adjusting to the program or, if the program is not meeting my needs or my child's needs, the teacher and the President of the Board will discuss and assist me in making alternate arrangements.
Signature: Signature*
Date: Date*

WBCNS Membership Agreement
I, {parentcaregiverName}, the parent / caregiver of {childsName}, understand that the co-operative is an organization whose successful operations depends on the participation and sharing of responsibilities of all co-operating families.
I, {parentcaregiverName}, the parent / caregiver of {childsName}. Therefore agree to abide the following:
- CONFIDENTIALITY: Keep all personal information pertaining to the children, parents, caregivers, garnered during school, meeting, etc., strictly confidential.
- MEETINGS: Attending membership, educational and orientation meetings, as scheduled.
- COMMITTEES: Working on one committee, attending the committee meetings and providing a report on work done.
- FINANCES: Paying the fees as outlined in the financial agreement and supporting fundraising activities planned by the membership.
- CONFLICT: Any conflict that may arise with other families, Board Members or Teachers shall be discussed exclusively with the HR committee for facilitation towards a positive result.
- WITHDRAWAL: Understanding that enrolment after one-month trial is for one year. Request for refund for withdrawal must be in writing and are at the discretion of the Board.
- ADMINISTRATION: Adhering to the principles of the co-operative incorporation.
For a superlative school, and for happy relationships among parents, the Board, the children and the ECE, we agree to abide by the Agreement outlined above.

Signature: Signature*
Date: Date*

Medical Waiver
I, {parentcaregiverName}, the parent/caregiver of {childsName}, understand that in the even of an accident or illness occurring to my child, the school will make every attempt to contact me and/ or my spouse, failing this my emergency contact(s) will be contacted. If however, I or my spouse, or emergency contact(s) cannot be reached, I hereby give Wasaga Beach Co- operative Nursery School Inc., its Directors, Officers, Agents and Employees authority to act on my behalf in case of an emergency and to take appropriate steps to have a doctor attend to my child.

I, {parentcaregiverName}, the parent/caregiver of {childsName}, hereby grant the Employees of the Wasaga Beach Co-operative Nursery School Inc., to provide First Aid for my child in the event of an injury.

I also agree to release and indemnify Wasaga Beach Co-operative Nursery School Inc., its Directors, Officers, Agents and Employees from all claims for damage arising from any injury of otherwise related actions to my child as a result of any accident, illness, injury or for any other reason arising from participation in school activities.

I, {parentcaregiverName}, the parent/caregiver of {childsName}, have read and understand the above.

Signature: Signature*
Date: Date*

Parent Handbook Agreement
Parent Handbook, Program Statement & Policies and Procedures Manual

I, {parentcaregiverName}, the parent/caregiver of {childsName}, have read and understand the entire Parent Handbook, Program Statement & Policies and Procedures Manual for Wasaga Beach Co-op Nursery school. I have discussed any questions or concerns I have with either a member of the Board of Directors or the Teachers and am completely satisfied with the response received.

In working towards a cooperative environment, I do agree to abide by these policies and procedures to retain my child’s space in the nursery school program.

Signature: Signature*
Date: Date*

WBCNS Pandemic Policy & Protocols

Acknowledgement & Attestation Form
I {parentcaregiverName}, hereby declare that I have received and read through the Wasaga Beach Cooperative Nursery School’s Pandemic Policy & Protocols (last updated February 2022).

WBCNS has made all required changes to their contagious illness protocols, hygiene and disinfecting practices as mandated by the Simcoe Muskoka District Health Unit, the Ministry of Education and the Ministry of Labour to reduce the spread and risk of exposure to COVID-19.

I , {parentcaregiverName} acknowledge that by choosing to send {childsName} to WBCNS this year there is a known risk that my child or myself might be exposed to COVID-19.

Signature: Signature*
Date: Date*
Should be Empty:

WBCNS Child Registration Form 2024/2025

Child Information

Family Contact Information

Emergency Contacts / Authorized Pickups

Medical Information

Social and Developmental History

WBCNS Parent Contract

WBCNS Membership Agreement

Medical Waiver

Parent Handbook Agreement

WBCNS Consent Form

WBCNS Pandemic Policy & Protocols