After School Program Registration

The College of Piping School Age Program

For children in grades K-6
Childs Name

First NameLast Name
Birth Date

MonthDayYear
Age as of September 8th 2026 (Start date)
Current grade as of September 8th 2026
Home address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Any medical conditions or allergies we need to be aware of *** Please note a small snack will be provided, if your child has any dietary requirements we ask that you please provide an after school snack***
Primary pickup contact

NameRelation to child
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Approved alternate pick up contact

NameRelation to child
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Approved alternate pick up contact

NameRelation to child
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Approved alternate pick up contact

NameRelation to child
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Are there any individuals who are not permitted to pick up your child
Name of person not permitted to pick up my child

NameRelation to child
Name of person not permitted to pick up my child

NameRelation to child
Name of person not permitted to pick up my child

NameRelation to child
Name of person not permitted to pick up my child

NameRelation to child
Emergency contact (can be same as primary pick up)

NameRelation to child
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Would you like to sign this child up for all day PD day care on applicable PD days? Cost is $45 per PD day will be added separately as they occur
Please submit a voided cheque for payments of $150 to be withdrawn biweekly ($15 per day non negotiable)

Cancelof

I hereby grant permission to The College of Piping and Celtic Performing Arts of Canada's School Age Program and its representatives to photograph and video the student, and otherwise capture images of the student during the regular teaching year, recitals, performances and events. These images and the students name may be used for promoting, publicizing or explaining The College of Piping and Celtic Performing Arts of Canada and its activities for administrative and educational purposes.
Rules, Regulations and Assumption of Risk - PLEASE READ CAREFULLY

School Aged Program Rules and Regulations

- Start date for this program is Tuesday September 8th 2026
- All children must be picked up by 5:00pm and drop off time starts at 2:30pm
- The after school program will follow the Public School Branch (Three Oaks Family of Schools) system with cancellations. Meaning if school is cancelled the after school program will also be cancelled.
- If a child is not going to be attending for the day, or there are changes made to pick up time or contact this is to be communicated to our program coordinator, via email (afterschool@collegeofpiping.com) or by phoning our front office manager Erin Clow at (902-436-5377)
- A small snack will be provided but if your child has any dietary restrictions you are to provide them with a snack for after school.
- A voided cheque is required for biweekly payments of $150, $15 per day non-negotiable.

Assumption of Risk

I understand that participation in The College of Piping’s School Age Program may involve activities, movement, transportation to or from program activities, interaction with other students, and the use of facilities, equipment, and personal belongings. I acknowledge that participation may involve risks of injury, accident, loss, or damage to personal property.

I voluntarily permit my child to participate in the School Age Program and acknowledge that I have considered the potential risks associated with participation.

Release of Liability

To the fullest extent permitted by applicable law, I agree to release and hold harmless The College of Piping, its employees, instructors, volunteers, representatives, and affiliates from claims arising from my child’s participation in the School Age Program, including claims relating to personal injury, illness, accident, loss of personal property, or damage to personal property, except to the extent that such liability cannot legally be waived or excluded.

I understand that The College of Piping is not responsible for lost, stolen, or damaged personal belongings brought to the program. Students are encouraged not to bring valuable or unnecessary personal items.

Medical Treatment

In the event of an emergency, I authorize The College of Piping and its staff to seek appropriate emergency medical assistance for my child when I or the emergency contact cannot be reached. I understand that I am responsible for any resulting medical expenses, to the extent permitted by law.

Parent/Guardian Acknowledgement

By signing below, I confirm that:

● I have read and understood this waiver.

● I understand the potential risks associated with participation in the After-School Program.

● I voluntarily authorize my child to participate.

● I agree to the terms of this waiver to the fullest extent permitted by applicable law.

● I understand that this waiver does not remove any rights or responsibilities that cannot legally be waived.
Place Holder Fee
One Time Convenience Fee
Total
Total due today

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