Registration Form 2026-2027

Registration Form 2026-2027

BEDROCK PLAYSCHOOL
$25 Non-Refundable Registration Fee

Please e-transfer to bedrockpayments@gmail.com after you submit this form to complete your child's registration. Only one fee per family (ie: if you are enrolling two children your fee is still $25). Your child(ren) will not be guaranteed a spot in class until this fee is received.
Student's Name

First NameLast Name
Student's Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student's Age
Student's Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Allergies or Food Restrictions
Special Medical, Physical, Emotional or Educational Needs
Parent 1 Name   First Name*   Last Name*   Area Code*   Phone Number*      Email*
Parent 2 Name   First Name*   Last Name*   Area Code*  Phone Number*
Email*
Emergency Contact Name & Phone Number (this CANNOT be a parent listed above)
Medical Information: Does your child have any medical needs we should know about, or require any medications while at school? If so, please list. Medications will require an additional form to administer.
Are your child's immunizations up to date
Guardianship, Custody or Access rights - Does such an order exist?
LEAVE CONSENT: I hereby give my consent for my child to leave the classroom on outings under the supervision of the Playschool staff, within an one block radius of the Knox United Church
PHOTO CONSENT: I allow for photos of my child to be taken and used for Playschool purposes such as yearend albums and bulletin boards
PRIVACY POLICY - The information you supply in this registration form will be made available to the teachers and all of the board members. We also publish a class list and phone list of the families within the playschool so that you can exchange helper days, etc.
Please check here if you DO NOT want your NAME/PHONE NUMBER published on the class phone list.
Policy Agreement - have you read, understand and agree to abide by all of the Bedrock Playschool policies, instructions and regulations as written in the 2026-2027 Handbook available on the website: www.bedrockplayschool.com
FIRST AID- I give permission for the staff of Bedrock Playschool to administer first aid to my child named above, when necessary.
Will your child be attending kindergarten in 2027?
CLASS SELECTION

Classes are filled on a first-come, first-served basis. Families will be added to a wait-list if their desired class reaches capacity and notified if a space becomes available.

THREE YEAR OLD CLASSES

Rows	First Choice	Second Choice	Third Choice
3 YEAR OLD Mon & Weds 9 - 11:30 AM
3 YEAR OLD Mon ONLY 9 - 11:30 AM
3 YEAR OLD Weds ONLY 9 - 11:30 AM
3/4 SPLIT Mon & Wed 12:30-3

FOUR YEAR OLD CLASSES

Rows	First Choice	Second Choice	Third Choice
3/4 SPLIT Mon & Weds 12:30 - 3 PM
4 YEAR OLD Tues & Thurs 9-11:30 AM
4 YEAR OLD Tues ONLY 9-11:30 AM
4 YEAR OLD Thurs ONLY 9-11:30 AM

Tuition Assistance Program: if you experience financial barriers for your child to access playschool, there is a small pool of funds raised by Bedrock Playschool for tuition support. You can opt in to this program by selecting "YES" below. Please note funds will not cover all of the school fees and they are not guaranteed:
Bedrock Playschool Child Abuse Pledge
I,   First Name*   Last Name*   understand and agree that as an employee, volunteer, or student at Bedrock Playschool, the children entrusted to our care are our central focus and as such will be treated with respect and dignity; abuse of any kind to a child is intolerable and cannot be condoned.

I understand that child abuse is defined in the Child Abuse Policy of the Association, as sexual, physical, psychological, or emotional abuse, molestation or harassment, including corporal punishment.

I agree that I will not subject the children to abuse of any kind. Furthermore, I agree that should I witness or become aware of child abuse that it is my responsibility to report this incident to my immediate supervisor, the teacher, or board member.

I understand that should I abuse a child, or fail to report child abuse that this action may result in my dismissal from my position with Bedrock Playschool.

Dated at Drumheller   Date*
Signature*
Should be Empty:

Registration Form 2026-2027

$25 Non-Refundable Registration Fee

CLASS SELECTION

Bedrock Playschool Child Abuse Pledge