2026/2027 RPP Preschool Registration Form

26/27 Preschool Registration Application

Rutland Parent Participation Preschool Society
Information of Child
Name*

First NameLast Name
Birth Date*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gender*

FemaleMale
Days of the week desired:*

MondayTuesdayWednesdayThursday
Rates Reminder:

2 days per week:$212 monthly commitment

3 days per week: $265 monthly commitment

4 days per week: $320 monthly commitment

We are currently enrolled in the ChildCare Fee Reduction Initiative which subsidizes a portion of the prices at RPPP.

The prices here reflect the price after that discount.
Information of Parent/Guardian 1
Name*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Information of Parent/Guardian 2
Parent Guardian 2:*

Lives with Parent/Guardian 1Lives Elsewhere (Please complete address and contact info below)Not Applicable
Please upload any relevant custody orders that are currently in place.

This is compulsory and is for your child's protection and well-being.
Cancelof
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.
Email Address
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Alternate Emergency Contact 1
In the event of an emergency/urgent pick up need, if neither parent is available, please contact:

Please do NOT put your 2 primary caregivers here. We are required to collect 2 alternate emergency contacts that you trust to pick up, and/or care for, your child. If you do not have 2 safe emergency contacts, please reach out to Teacher Kristel @ (250)448-1758 for guidance.
Name*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Name*

First NameLast Name
Alternate Emergency Contact 2
In the event of an emergency/urgent pick up need, if neither parent is available, please contact:

Please do NOT put your 2 primary caregivers here. We are required to collect 2 alternate emergency contacts that you trust to pick up, and/or care for, your child. If you do not have 2 safe emergency contacts, please reach out to Teacher Kristel @ (250)448-1758 for guidance.
Relationship*
Phone Number*
Please enter a valid phone number.
Email Address
example@example.com
Other people authorized to pick up child from school
Name*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
Are there any person(s) not permitted access to your child? Please list them (First and Last Name) below:
Please note that a court order is required to prevent access from a legal guardian.
Medical Information

If you do not have a family doctor, please list your most recent/preferred Walk -In Clinic
Doctor's Name*

First NameLast Name
Doctor's Phone Number*
Please enter a valid phone number.
Child's Care-Card Number:*
Please do NOT leave blank
Please list any of the following: Current medications, known/suspected allergies, special diet (for any reason - ie: kosher, vegan, halal, dairy free), medical diagnosis or concerns you wish to disclose:*
Is your child Potty trained?*

YesNoIn progressOther
Does your child require any extra support to integrate or participate safely?*
Please upload a photo of your child's face for our emergency files. Please ensure it is appropriate to identify your child in an emergency (no nudity, face must be clearly visible, no other people in this photo - cropping is fine)

Cancelof
Please upload a photo of your child's Birth Certificate here*

Cancelof
Please upload any immunization/vaccination records for your child here. If you do not have any vaccination records, or if you are missing records, we will ask you to complete a status declaration to keep on file in event of a transmissible outbreak within IH.

Cancelof
Below is the PDF link for our Handbook. Please ensure you read and download this Handbook. Paper copies can be requested as well in class. To view, please click on the image below:
I have read and agree to follow the guidelines in the RPPP Family Handbook.*

Yes
I understand that this application is not a guarantee of acceptance. Once a space is available, I will be notified. If there is space for my child, I agree to pay a non-refundable fee of $100. This should only be done *AFTER CONFIRMATION* Payments are accepted via Cash, Cheque, or eTransfer to rppptreasurer@gmail.com*

I understand and I will pay my registration fee after receiving confirmation
Signature: (sign below)
Should be Empty:

26/27 Preschool Registration Application

Information of Child

Information of Parent/Guardian 1

Information of Parent/Guardian 2

Medical Information