New Customer Registration Form

  • WillowTree Children's Society

    Child Registration Form
  • Requested Start Date:
     - -
  • What type of care of you looking for?*
  • What days of the week do you require childcare?*

  • Child's Details:

  • Child's Date of Birth*
     - -

  • Parent/Legal Guardian Details:

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Emergency/Pick Up Contact Details:

    Persons other than parents/legal guardians that are allowed to pick up your child in case of emergency or incase parents/legal guardians are unable to pick up their child.
    Please provide us with at LEAST ONE contact. If you require more space for additional pick up persons please ask adminitration team for an additional contacts form.
    *Parents/legal guardians must notify educators if someone other than themselves will be picking up their child even if they are listed on this form. 

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Court Orders: 
    Please provide administration team with copies of any court orders that may restrict contact, specify parental guardianship, or pertain to your child. 

  • Child's Medical Information:

  • Does your child have or have they had any of the following:

  • Emergency Medical Consent - Please sign

    I grant permission for the educators of WillowTree Children's Society to take whatever steps necessary to obtain medical treatment for my child if warranted. These steps may include but are not limited to; attempt to contact parent/guardian or emergency contacts, administer first aid, have child transported to an emergency or hospital facility in the company of a educator. I understand and accept that it is my responsibility to cover the cost of any ambulance or medical expenses should this occur. I also grant permission and give consent to medical or surgical treatment by a licensed physician and/or hospital, and further consent to the administration of any necessary anesthetics, medical treatments, tests, transfusions, infections, or medical drugs, and the performing of whatever operations may be deemed necessary or advisable in the event of a medical emergency involving my child.

  • Illness - Please initial

    I understand my child must remain home if for any reason they are not well enough to take part in all aspects of the program. If my child should become ill after arrival, myself or emergency contacts will be notified and asked to come and take my child home as soon as possible. *See Child Illness policy in Parent Handbook

  • Pick up - Please initial

    I understand that I must notify WillowTree Children's Society should anyone other than myself or the child's legal guardian be picking up the child from care, even if they are listed as a contact. Pick up persons, if a stranger to the staff, must provide government issued picture ID. I understand the WillowTree Children's Society staff reserve the right to refuse ANYONE picking up a child who does not appear to be in a responsible condition.

  • Fees - Please initial

    I understand that the monthly fee for childcare is due and payable on the last day of the month preceding the month that care is provided. I understand that there will be a late fee applied for late payments and/or late pick ups as outlined in the WTCS Parent Handbook. I also understand I must pay the full fee for all days that I schedule my child to attend and that if my child does not attend all days due to sickness, change in plans, etc., I am still responsible to pay for all scheduled days. The administration team reserves the right to terminate care should any fees not be paid on time.

  • Schedule - Please initial

    I understand I must provide WillowTree Children's Society Administration team with a full calendar including drop off and pick up times for my child by the 15th of the month preceding. I understand that should I wish to terminate my child's care I must provide one (1) full month written notice. If I fail to provide written notice, I will be required to pay one additional months fee.

  • Off Site Permission - Please sign

    I understand that the WillowTree Children's Society Educators take frequent community walks and attend community events. Educators will remain in proper child to staff ratio when doing so. I hereby grant permission for my child to leave the center premises on an on-going daily basis for outdoor walks, minor field trips including library visits, sledding, school visits, and other such related activities. This includes walking to and from Hughenden School for OSC school transportation.
  • The WillowTree Children's Society Educators photograph children in their daily activities and during special events. Photos are posted on our PRIVATE Facebook page that is only accessed by current families. Do you give permission for your child to be photographed and posted on our private Facebook page?*
  • The WillowTree Children's Society Educators may give my child's first name to other families on special occasions such as Valentine's Day, etc.*

  • WillowTree Policies - Please sign

    I understand that it is my responsibility to read and understand all policies in the WillowTree Children's Society Parent Handbook. I understand that this handbook is frequently updated and it is my responsibility to keep up with any changes made by the society and hereby agree to any changes made. I acknowledge that the WillowTree Children's Society endeavors to provide the best possible care for all children enrolled in the program. Accordingly, I acknowledge that the WillowTree Children's Society reserves the right to refuse enrollment or the continued enrollment of my child, should the society determine that my child poses a health, behavioral or management program to its operation, staff, or other children in care.
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