REGISTRATION FORM FOR ADMISSION 2025-2026

PARENTS & GUARDIANS
Mother's Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Father's Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Person responsible for transportation (other than parent/guardian)
1. Name:*

First NameLast Name
Relationship to child*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
2. Name:*

First NameLast Name
Relationship to child*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
3. Name:*

First NameLast Name
Relationship to child*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
* Please be sure to provide a piece of ID for ALL individuals responsible for pick-up / drop-off

** If both parents do not have equal access/custody of this child, please provide us with documentation

B) Medical Information:
OHIP CARD:*
Family Physician*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred Hospital
Insurance/Health Coverage (Company)
Has your child been diagnosed with any disease? Please specify.*
Has your child been immunized? *
Name of Health Unit? *
Has your child’s vision been checked? *
Corrective lenses required? *
Has your child’s hearing been checked? *
Does your child sleep well? *
Has your child ever had any serious illness or accident? Please specify? *
If your child has eczema, asthma or allergies, please specify and describe reaction:*
If your child is receiving medication on an ongoing basis, please describe, including any potential side effects:*
Please describe your approach to ensuring your child is on a healthy diet, including limiting sugar.*
Does your child have a nap? *

C) General Information:
Language(s) spoken at home:*
Citizenship:*
If not a Canadian Citizen, type of visa and expiry date: *
Does your child have any behavior problems that you are aware of? Please describe, including any environmental or medical factors that may set these off. *
Please give a brief outline of your approach to discipline at home.*

D) Academic Information:
Previous School / Day Care
City
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact:
ReadingWritingMathStudyDisciplineAttentionSocializationOther
By enrolling in Alive Montessori Preschool, what do you hope to achieve for you child?*
Notes
Please inform the office of any other vital information you think they may need to know in the event of an emergency. Thank you.
Parent / Guardian signature*

REGISTRATION FORM