REGISTRATION PACKAGE 2026-2027

Nelephant Montessori School

Registration Package Part 2
This is the second part of the registration process. Please submit all forms no later than April 17th.

For all "Signature" fields, you will be drawing your signature with your mouse (or your finger if using a touch screen). You can hit the clear button and try again until you are happy with it. We do not expect it to be perfect - just unique to you.

Please read and complete the following forms carefully. Please double check all dates/phone numbers/etc. to ensure we have correct information on file for your child.

If you have any questions along the way, please don't hesitate to contact us.
Head of School - Jodi Sproule

jodi@nelephant.ca
Toddler Supervisor - Danielle Barnfield

toddler@nelephant.ca
Nelephant Montessori - Main Office

info@nelephant.ca (financial related matters and Admin. Assistant)

REGISTRATION FORM

2025-2026
Are you registering for Toddler or Casa?
Child's Full Name:
Child's Gender:
Child's Date of Birth:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Child's Health Card Number:
Child's Home Address

Street Address

Street Address Line 2 (Apartment or Unit number)

CityProvince

Postal Code
Parent/Guardian #1
Parent/Guardian #1 Full Name:
Parent/Guardian #1 Relationship to the child:
Parent/Guardian #1 Email:
example@example.com
Parent/Guardian #1 CELL Phone Number:

Area CodePhone Number
Parent/Guardian #1 HOME Phone Number:

Area CodePhone Number
Parent/Guardian #1 lives at the same address as the child (if no, please fill in next question):
Parent/Guardian #1 Home Address if different than child's:
Parent/Guardian #1 Occupation (Please tell us what you do for a living or what your profession/industry is, not just your job title - i.e.: Doctor, Teacher, Painter, etc.):
Parent/Guardian #1 Place of Business (What is the name of the company where you work?):
Parent/Guardian #1 Business Address:
Parent/Guardian #1 Business Phone Number:

Area CodePhone Number
Parent/Guardian #2

(Please complete this information in full if there is a second parent/guardian who will be interacting with the child. In the case of single parent/guardian homes, you may skip this section.)
Parent/Guardian #2 Full Name:
Parent/Guardian #2 Relationship to the child:
Parent/Guardian #2 Email
example@example.com
Parent/Guardian #2 HOME Phone Number

Area CodePhone Number
Parent/Guardian #2 CELL Phone Number

Area CodePhone Number
Parent/Guardian #2 lives at the same address as the child (if no, please fill in next question):
Parent Guardian #2 Home Address if different than child:
Parent/Guardian #2 Occupation (Please tell us what you do for a living or what your profession/industry is, not just your job title - i.e.: Doctor, Teacher, Painter, etc.):
Parent/Guardian #2 Place of Business (What is the name of the company where you work?):
Parent/Guardian #2 Business Address:
Parent/Guardian #2 Business Phone Number

Area CodePhone Number
Please list the names of the people allowed to pick up your child from school other than Parents/Guardians.
Name of Person #1:
Telephone Number of Person #1:
Relationship to child of Person #1:
Name of Person #2:
Telephone Number of Person #2:
Relationship to child of Person #2:
Name of Person #3:
Telephone Number of Person #3:
Relationship to child of Person #3:
Name of Person #4:
Telephone Number of Person #4:
Relationship to child of Person #4:
In an EMERGENCY, if you cannot be reached, we can notify (Must include at least 1 person. Must be other than Parents/Guardians listed above):
Name of Emergency Person #1:
Telephone Number of Person #1:
Relationship to child of Person #1:
Name of Emergency Person #2:
Telephone Number of Person #2:
Relationship to child of Person #2:
Child's Medical Information
Doctor's Name:
Doctor's Phone Number:
Please list any Allergies child has or mark as N/A:
Please list any Medical Conditions child has or mark as N/A (i.e. Asthma, etc.):
Please list any medications required or mark as N/A (If your child requires an Epi-Pen, puffers, Benadryl, etc. at school, please be sure to list here.):
Please list any communicable diseases child has had or mark as N/A:
Does child have any special requirements in respect to diet, rest, physical activity or any other accommodations needed?
If yes, please describe (If Epi-Pen, puffers, etc. are required, please briefly describe when those would be needed including symptoms.):
Requires Signature of both parents/guardians (if applicable).
Parent/Guardian Signature:
Parent/Guardian Signature:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Nelephant Media Release Form
It is the policy of Nelephant Montessori School to promote the school in the community through our website and social media. It is also the school’s policy to obtain permission to use photos of the children. The pictures will at times be shared with other Nelephant families when your child appears in a picture with their friends.
Do you give consent for your child's pictures to be shared?
I, Parent/Guardian Name give Nelephant Montessori School permission to use photographs of the child listed below in the capacity identified above. Such permission is given until Nelephant is notified in writing that permission is revoked.
I represent that I am the parent or legal guardian of the child listed below, that I have read the above paragraph, fully understand its contents, and am able legally to enter into this agreement.

This agreement is entered into under the laws of the Province of Ontario, Canada, and shall be governed and interpreted in accordance with the laws of this province.
Child's Full Name:
Parent/Guardian Signature:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Disclaimer:
During off-site events or activities taking place outside of school property, Nelephant Montessori School is not responsible for, nor does it have control over, photographs or recordings taken by members of the public that may incidentally include Nelephant students. Nelephant assumes no liability for the capture, use, or distribution of such images or recordings on platforms or pages not officially managed by Nelephant Montessori School.
Nelephant Outdoor Excursions Form
At times throughout the school year, children go on short walks around the neighbourhood of the school.

I give permission for my child to go on school excursions within walking distance of the school, under the direct supervision of the teachers. I understand that a permission form will therefore not be required for each of these small trips. This permission form will be considered valid for the duration of the school year.

A separate permission form will be provided prior to any trips not within walking distance of the school.

We walk to Westhills Care Center multiple times each year to visit with the residents. These trips will be marked on the monthly calendars, but we will not be sending a separate permission form each time. It is included in this general permission form. If you do NOT wish to have your child participate in our Westhills trips, please check the appropriate box below and it will be your responsibility to keep your child home on the days of our visits.
I give permission for my child to attend the Westhills Care Centre trips when they happen throughout the year.
Child's Full Name:
Parent/Guardian Signature:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Privacy Policy/Authorization to Share Information
On January 1 2004, the Personal Information Protection and Electronic Documents Act (PIPEDA) covering the collection, use or disclosure of personal information in the course of any commercial activity took effect. This includes provincially regulated organizations as well. Our responsibilities under this act are fairly extensive, but in general, we are mandated to inform you of the purpose of all personal information we collect from you.

During registration and subsequently, we have collected information from you in order to:
- best meet your child’s needs
- give your child the best education possible
- meet legal, contractualand regulatory responsibilities (Child Care and Early Years Act/Public Health etc.)
We do not sell your information to third parties. Our procedures and systems are designed to protect your information from error, loss or unauthorized access. Those people who have access to your personal information must enter into privacy, (confidentiality) agreements with us and you.

If you have a question or concern regarding the collection and protection of your personal information please do not hesitate to speak to the Office.
NELEPHANT MONTESSORI SCHOOL PRIVACY POLICY - AUTHORIZATION TO SHARE INFORMATION
Parent/Guardian Full Name:
1. I am aware that Nelephant Montessori School has a Privacy Policy.
2. I hereby give permission to Montessori School to share relevant information in order to meet the needs of the school and its programs.
3. I give permission to include my name, email address and phone number for the purpose of a class list to be distributed to other parents at the school. (Please complete the Class List form on the next page.)
Parent/Guardian Signature:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
NELEPHANT MONTESSORI SCHOOL ANTI-SPAM LEGISLATION
In accordance with Canada’s Anti-Spam Legislation (CASL) that came into effect on July 1, 2014, Nelephant Montessori School requests your permission to email, send social media invites or instant message you regarding information solely about the school and school events.
Parent/Guardian Full Name:
I give Nelephant Montessori School Permission to contact me in any of the forms mentioned above.
Parent/Guardian Signature:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Class List Information
Please fill out whatever information you feel comfortable sharing with the other Nelephant families at our school. The class lists are emailed to all our families in September to allow parents to contact each other for playdates, birthday parties or other social reasons. They are also used by the Committees to share any events they have planned throughout the year. If you choose not to be part of the class list, please leave this form blank.
Parent/Guardian #1 Name:
Parent/Guardian #1 Phone Number:
Parent/Guardian #1 Email:
example@example.com
Parent/Guardian #2 Name:
Parent/Guardian #2 Phone Number:
Parent/Guardian #2 Email:
example@example.com
Child #1 Name:
Is child in Casa or Toddler:
Child #2 Name:
Is child in Casa or Toddler:
Child #3 Name:
Is child in Casa or Toddler:
I give Nelephant Montessori School permission to share the above information with other Nelephant families for the purpose of a class list.
Parent/Guardian Name:
Parent/Guardian Signature:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

QCCN Information
Quality Child Care Niagara (QCCN) is a standardized training approach designed to improve the quality of programs offered to each child enrolled in our childcare program. This approach provides our Staff with a framework within which programming decisions can be made. It promotes early identification supporting timely referrals to the right community resources.

As part of QCCN we use the following checklists:

Developmental Preschool Screen (DPS) (completed yearly on all children under the age of 5): Diagnostic Inventory for Screening Children, Preschool Screen (DPS)
- Early developmental screening tool designed to screen large groups of children between the ages of 6 – 60 months
- Reliable in identifying children who may be at risk of developmental delay
- Sets the stage for a smooth transition to the formal school system
Speech & Language Developmental Checklist (completed yearly on all children under the age of 4):
- Checklist that examines all elements of speech and language development for children birth to four years
- Identifies children who may be at risk for speech and/or language delay or disorder
- Complements the Developmental Preschool Screen (DPS)
- Provides a user-friendly format for recording of observations, obtaining a baseline record of skills and sharing the information with families
Environmental Rating Scales:
- Variety of environmental rating scales, geared to childcare environments and children’s age groups designed to enhance the quality of developmental programming
Behavior Checklist: Children’s Actions, Relationships, & Emotions (C.A.R.E.):
- An intervention planning tool that identifies behavior patterns in children ages 24 – 72 months
- Complements the Developmental Preschool Screen (DPS)
- Provides a format for recording of observations and sharing information with families
Record-keeping (Documentation):
- Clear record-keeping ensures that Developmental Preschool Screen (DPS) Environmental Rating Scales, Speech/Language and Behavior Checklist scores are recorded in a standardized way to support program planning for all children
- Surveys are distributed once a year to obtain standardized feedback from parents/guardians
- Written permission is required from the parent/guardian before using any checklist.
DISC Preschool Screen (DPS)
Once a year, a developmental screening tool is completed with each child called the Disc Preschool Screen (DPS It is a simple 15-20 minute developmental checklist based on 12 items, using specific toys on a 1:1 basis. Based on the results of the Disc Preschool Screen, one of the following suggestions will be made:
- Score of 7-12: No further developmental screening is required unless follow up is requested by the Early Childhood Educator or parent.
- Score of 6 or below: A referral to a Resource Teacher is suggested for follow up with second stage screening with Diagnostic Inventory for Screening Children (DISC)
We are requesting your consent to have our staff complete the Disc Preschool Screen (DPS) with your child. The results will be shared with you. Do you consent?
Child's Full Name:
Child's Birthdate:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent/Guardian Signature:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature of Witness:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Speech & Language Developmental Checklist
The Speech & Language Checklist is a screening tool completed on an annual basis with children from birth to 4 years.

Based on the results of the checklist, a referral to Speech Services Niagara program at Niagara Children’s Centre may be completed by the educator with Parent Consent.

The Speech & Language Checklist has been implemented to support all children to address any concerns where a child may be experiencing some challenges with speech and/or language.
We are requesting your consent to have our staff complete the Speech & Language Checklist screening tool with your child. The results will be shared with you. Do you consent?
Child's Full Name:
Birthdate:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature of Parent/Guardian:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Authorization for Non-Prescription Skin Products
Child's Full Name:
Date of Birth:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
There may be times throughout the year that your child requires the use of non-prescription products while they are at school. These may include such things as sunscreen or lotion.

We require your permission before we can allow your child to use any of these products while at school.

Any products that you provide must come in the original container and have your child's name clearly written on the label.

If you choose to check off any of the products listed below, please make sure to fill in the names of the products in the following spaces. Example, if you check off "Sunscreen", in "Product 1", please write "Sunscreen" and the name brand if you know what it will be.
The following non-prescription items may be applied to my child in accordance with the manufacturer’s instructions on the original container (Please check off all that YOU PLAN TO SUPPLY to the school. Nelephant will supply hand sanitizer when needed. Please check that box if you agree to allow your child to use school provided hand sanitizer.):
If "Other" please describe:
I understand that at times throughout the year, Public Health will recommend that Nelephant use alcohol based hand sanitizer for children and adults entering the school. This product will be supplied by Nelephant and only used when necessary. It will have a minimum of 70% alcohol content.
Nelephant Montessori will provide Alcohol Based Hand Sanitizer when necessary. Parent/Guardian will supply the following non-prescription products if needed by your child (please include the name of each product listed above that you plan on providing for your child - sunscreen, lotion, etc.):
Name of Product 1:
Name of Product 2:
Name of Product 3:
Name of Product 4:
Name of Product 5:
*Any product being supplied by the family must come in its original container clearly labelled with your child’s name on it. It must be left at school and you will be notified if and when we require more.

**You understand that you are required to apply sunscreen to your child prior to arriving at school each morning. Nelephant will only re-apply if the children go outside for a second time later in the afternoon.
Parent/Guardian Signature:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Pre-Authorized Payment Agreement
Child's Name:
Nelephant Montessori School uses Pre-Authorized Payments for all tuition and other monthly payments collected from parents/guardians. This is our prefered method of payment. Please speak with the office (info@nelephant.ca or 905-704-1388) if you absolutely cannot participate in Pre-Authorized Payments for some reason, or if you are choosing to pay the entire tuition amount up front.

Account Holder Information
First and Last name(s) of account holder(s):
Telephone Number:
Home Address:

Address (street, city, province)

Street Address Line 2

CityState / Province

Postal code
The name of the financial institution where the account is located:
Institution Number:
Transit Number:
Account Number:
Payee Contact Information

Garden City Nursery School Inc. o/a Nelephant Montessori School

134 Louth St. St Catharines ON, L2S 2T4

905-704-1388

info@nelephant.ca
Withdrawal Authorization

I/we authorize Garden City Nursery School o/a Nelephant Montessori School and the financial institution designated (or any other financial institution I/we may authorize at any time) to begin deductions as per my/our instructions for monthly recurring payments and/or one-time payments from time to time, for payment of tuition and payment of charges arising from time to time. Regular monthly payments for the full amount of services delivered will be debited to my/our account on the 1st of each month.

This authority will remain in effect until Garden City Nursery School o/a Nelephant Montessori School has received written notification from us/me of the change or termination. This notification must be received at least ten (10) business days before the next debit is scheduled at the address provided above.

I/we have certain recourse rights if any debit does not comply with this agreement. For example, I have the right to receive reimbursement for any PAP the is not authorized or is not consistent with this PAP Agreement. To obtain a form for a Reimbursement Claim, or for more information on my/our rights, I/we may contact my/our financial institution or visit ww.cdnpay.ca
Parent/Guardian Name:
Authorized Signature:
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please upload a copy of a VOID cheque or a direct deposit slip so we are able to verify your banking information.

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PD Day Fund

An opportunity to support our teachers & your child's learning.
Nelephant is a part of the $10/Day agreement (CWELCC) with the federal government which allows us to keep our tuition costs very low. This program provides funding from the government for a predetermined number of days in each school year, including what are called 'Allowable Closure Days' when the school is closed for professional development and other breaks. As of January 1, 2025, the government unexpectedly asked us to include Statutory holidays in our Allowable Closure Days, which we have not done previously. What that means now, is that our 8 Professional Development Days – which are essential for maintaining the high quality of education and care your child receives – are no longer funded.

In real terms, this means that as we continue providing Professional Development for our staff, we will be short approximately $25,000 per year in staff wages.

Why Do PD Days Matter?

PD days are opportunities for growth, collaboration, and renewal that directly impact the experience your child has in the classroom. On these days, our teachers:
- Engage in workshops and conferences on child development, Montessori best practices, and innovative teaching methods.
- Learn from guest speakers who provide insights tailored to the unique needs of our school community.
- Plan lessons, create new materials, and bring fresh ideas into the classroom.
- Visit other Montessori schools to observe and gain inspiration to enhance their own teaching methods.
- Host Parent-Teacher Interviews, giving you a window into your child’s progress and growth.
- Build relationships with one another, strengthening the teamwork that fosters a warm and cohesive learning environment.
- These days are not a luxury; they are a necessity. They are what allow us to provide the exceptional education and care for your child that you entrust us with every day.
How You Can Help

We are asking you to donate your child’s $240 Enrollment Fee to our PD Day Fund. Typically, this fee would be deducted from your June tuition. If everyone chose to donate instead, we could raise just over $15,000—bringing us significantly closer to covering the cost of these vital learning days.

Both the Administration and the Board of Directors are committed to continuing to provide quality Professional Development for our teachers. We believe it is the only way to ensure the high-quality education for which Nelephant has always been known.

As a registered charity, we can provide a charitable donation receipt for your contribution.
Will you agree to donate your child's $240 Enrollment Fee to our PD Day Fund for this school year?
**Please note that you have already paid the $240 Enrollment Fee so there is no
need to send more money at this time.
Child's Name:

First NameLast Name
Parent/Guardian's Name:

First NameLast Name
Parent/Guardian's Signature:

Thank you so much!

Please double check your information (especially birth dates, phone numbers and email address) before clicking Submit to avoid any errors.
Should be Empty:

Nelephant Montessori School

Head of School - Jodi Sproule

Toddler Supervisor - Danielle Barnfield

Nelephant Montessori - Main Office

REGISTRATION FORM

Parent/Guardian #1

Parent/Guardian #2

Child's Medical Information

Nelephant Health History Form

IF YOUR CHILD HAS AN ANAPHYLAXIS ALLERGY OR OTHER MEDICAL NEEDS REQUIRING MEDICATION (SUCH AS ASTHMA OR DAILY MEDICATION TO BE GIVEN AT SCHOOL), PLEASE REQUEST THE APPROPRIATE ADDITIONAL FORMS FROM THE OFFICE

Nelephant Media Release Form

Nelephant Outdoor Excursions Form

Privacy Policy/Authorization to Share Information

NELEPHANT MONTESSORI SCHOOL PRIVACY POLICY - AUTHORIZATION TO SHARE INFORMATION

NELEPHANT MONTESSORI SCHOOL ANTI-SPAM LEGISLATION

Class List Information

QCCN Information

DISC Preschool Screen (DPS)

Speech & Language Developmental Checklist

Authorization for Non-Prescription Skin Products

Pre-Authorized Payment Agreement

PD Day Fund

Thank you so much!

Nelephant Montessori School

Head of School - Jodi Sproule

Toddler Supervisor - Danielle Barnfield

Nelephant Montessori - Main Office

REGISTRATION FORM

Parent/Guardian #1

Parent/Guardian #2

Child's Medical Information

Nelephant Health History Form

***IF YOUR CHILD HAS AN ANAPHYLAXIS ALLERGY OR OTHER MEDICAL NEEDS REQUIRING MEDICATION (SUCH AS ASTHMA OR DAILY MEDICATION TO BE GIVEN AT SCHOOL), PLEASE REQUEST THE APPROPRIATE ADDITIONAL FORMS FROM THE OFFICE***

Nelephant Media Release Form

Nelephant Outdoor Excursions Form

Privacy Policy/Authorization to Share Information

NELEPHANT MONTESSORI SCHOOL PRIVACY POLICY - AUTHORIZATION TO SHARE INFORMATION

NELEPHANT MONTESSORI SCHOOL ANTI-SPAM LEGISLATION

Class List Information

QCCN Information

DISC Preschool Screen (DPS)

Speech & Language Developmental Checklist

Authorization for Non-Prescription Skin Products

Pre-Authorized Payment Agreement

PD Day Fund

Thank you so much!

IF YOUR CHILD HAS AN ANAPHYLAXIS ALLERGY OR OTHER MEDICAL NEEDS REQUIRING MEDICATION (SUCH AS ASTHMA OR DAILY MEDICATION TO BE GIVEN AT SCHOOL), PLEASE REQUEST THE APPROPRIATE ADDITIONAL FORMS FROM THE OFFICE