REGISTRATION FORM FOR ADMISSION 2025-2026

PARENTS & GUARDIANS
Mother's Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Father's Name

First NameLast Name
Phone Number
Please enter a valid phone number.
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.
2. Name:

First NameLast Name
Relationship to child
Phone Number
Please enter a valid phone number.
3. Name:

First NameLast Name
Relationship to child
Phone Number
Please enter a valid phone number.
* 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.
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:
Does your child need special attention with any of the following? Please describe any difficulties.

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

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REGISTRATION FORM