Metcalfe Nursery School Registration Form 2022 - 2023 Child's Name * First Name Last Name Date of Birth * MM DD YYYY Program * Toddler: Tuesday & Thursday's Preschool: Monday/Wednesday/Friday Toddler Preschool Preschool Please select one or multiple dates you would attend. Monday Wednesday Friday Parent Name 1 * First Name Last Name Parent Cell Phone 1 * (###) ### #### Parent Name 2 * First Name Last Name Parent Cell Phone 2 * (###) ### #### Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Siblings * Must add all siblings names & ages. Emergency Contact Name * First Name Last Name Emergency Contact Phone * (###) ### #### Relationship to Child * Allergies * Health Concerns * Starting Date * MM DD YYYY Withdrawal Date * MM DD YYYY Payment Options * All options additionally require $75 registration fee payable when you register. All tuition cheques made payable to Rural Family Connections Inc. are due during the registration in-take interview in the first week of September. Cheque PAD: Pre-authorized debit Tuition & Fees * The following is an overview of the fees for the 2023 / 2024 school year. Registration fee (all programs): $75 per year (maximum $75 per family) Toddler Program 2 days/ week $105.50 Preschool Program 2 days/week 9am to noon $92.31 Preschool Program 2 days/week 9am to 2pm $152.98 Preschool Program 3 days/week 9am to noon $123.96 Preschool Program 3 days/week 9am to 2pm $184.63 I understand that I will be charged the above amount monthly for my child's tuition. * Liability Release * I understand that the Nursery School's programs include activities and field trips (with signed parental permission form) to public parks, museums, farms and other points of interest, including walks about the village. I hereby release Metcalfe Nursery School from any or all responsibility or liability arising from or out of any accident or event which may occur from any cause whatsoever on, or en-route to, or from the school premises. Medical Release * I hereby appoint the Manager, Teacher, or Substitute Teacher of the Metcalfe Nursery School to act in complete authority, to authorize any medical attention to my child by a qualified physician in the event of an emergency while my child is in the care of the Metcalfe Nursery School Inc. (There will always be constant attempts to contact the parents or emergency alternative first.) Photo Permission * From time to time we take pictures during Metcalfe Nursery School activities. We would like your permission to use these pictures on our website, in our newsletter, and/or in promotional materials. We will never reference your child by name or provide any specific information regarding your child. We also will never sell these pictures; we will use them exclusively for internal purposes and promotional activities for the Metcalfe Nursery School (including, but not limited to our website, newsletter, and brochures). Please take a moment to let us know your preferences regarding our use of photos for your child, please check of each line that you give permission for otherwise leave blank: YES. I grant you permission to use photos of my child in your promotional materials, including website & printed materials. YES. I grant you permission to take & use photos of my child only on the private MNS current families only facebook page & the on-line classroom site (StoryPark.com page) which is where we document your child's nursery school experience. YES. I grant you permission to use photos of my child only in your printed materials - no on-line use. NO. Please do NOT take or use any photos of my child. Parent Name & Date * Internal Communications * In order to reduce costs, we would like to correspond with you primarily by email. Please check below if this is not a suitable option for you. I do not wish to receive Metcalfe Nursery School communications by email. I wish to receive communication by email. Please provide a list of the authorized adults with permission to pick up your child: * Registration Completion Checklist * The following is a list of items that must ALL be submitted in order to successfully register your child in the Nursery School and hold your child's space: Registration form (both sides completed and signed) Registration fee ($75) Immunization Information form and copy of immunization card Pre-authorized debit signed form Intake Interview Checklist The following is a list of items that must ALL be submitted in September during intake interview: Cheque for Sept + June tuition Completed Police Records Check OR Vulnerable Sector Check for parents, volunteering in the classroom and field trips. Thank you for registering!