Little Bee Academy Registration Form

Registration Form
13008 122 Avenue NW, Edmonton, AB T5L 1M8
info@littlebeeacademy.ca / 587-709-0660

Please complete this form and email it to info@littlebeeacademy.ca
Full Time
Child's Name (first, last):

FirstLast
Child's Home Phone:
Format: (000) 000-0000.
Child's Birthday:

MonthDayYear
Date
MaleFemale
Child's Address (city, province, postal code)
Parent/Guardian #1 Name (first, last):

FirstLast
Parent/Guardian #1 Home Phone:
Format: (000) 000-0000.
Parent/Guardian #1 Cell Phone:
Format: (000) 000-0000.
Parent/Guardian #1 Work Phone:
Format: (000) 000-0000.
Parent/Guardian #1 Email:
example@example.com
Parent/Guardian #1 Address (city, province, postal code):
Parent/Guardian #2 Name (first, last):

FirstLast
Parent/Guardian #2 Home Phone:
Format: (000) 000-0000.
Parent/Guardian #1 Cell Phone:
Format: (000) 000-0000.
Parent/Guardian #2 Work Phone:
Format: (000) 000-0000.
Parent/Guardian #2 Email:
example@example.com
Parent/Guardian #2 Address (city, province, postal code):
YesNo
If yes, please explain your child's allergy/diet restrictions:
continue to page 2

Getting to know you
Child's Name (first, last):
First, Last
What foods does your child love?
What foods does your child dislike?
Any special dietary restrictions?
Favourite toys games or activities?
YesNo
If yes, what words do they use to communicate they need to use the toilet?
How does your child express anger or frustration?
Is your child especially afraid of anything specific? Please explain
When your child is upset, what helps to comfort him or her?
Does your child usually take afternoon naps? If so, for how long?
Specific blanket or sleep aid for nap time?
Any special family situation that we can support of help with?
Anticipates adjustment problems?
Any development delays diagnosed or suspected?
Has your child been known to bite? If so, we will create a plan together to prevent anyone from getting hurt and to successfully redirect the biting.
If you are comfortable, please share your families spirituality so that we can learn about it and support that area of development here at the centre with your child.
Should be Empty:

Registration Form