Checklist for Registration:

Registration Deposit fee of $20.00

Method of payments –

- 10 post dated cheques can be dated for 1st or 15th of each month- to be handed in September

- Pre-authorized credit card (Visa/Mastercard/American Express excepted) can be 1st

or 15th of each month (additional form will need to be filled out)

- E-transfer is accepted, however payments need to be made on the 1st of every month.

All registration forms need to be completed in full.The Government of Alberta’s Department of Childcare Licensing will check eachregistration form to ensure that all information is present.

Signed POLICY FORM (includes photo release, emergency procedures, feeagreement, cancellation, and privacy policies).

Parent Handbook and Discipline Policy is available on our website

Inspiration Station Preschool

08 Fall

INSPIRATION STATION REGISTRATION

2018/2019

- If other arrangements are necessary, please talk to Carla.

- Subsidy is available for eligible families through Government of Alberta. Carla will be happy to help you navigate the website and we will post the forms on this site. (http://www.humanservices.alberta.ca/financial-support/15104.html)

_______________________________`___________________________Class Request MWFam TTHam TWTHpm TTHpm West East

Child Information Child’s Name: Birth date: M or F

Last First Address: City: Postal Code: Home phone: Referred by:

Medical Information Are Immunizations up to date? Yes No

Severe Allergies: Yes No If yes, does your child require an Epipen? Yes NoPolicy requires a signed Medication Release Form and an Epipen be kept at school at all times. Please list allergens:

Other serious medical conditions (please describe):

Parent/Guardian Information Please note: Due to licensing policies, we cannot accept box numbers as addresses; we must have a land description

Name: Relationship to Child: Address the same as child: Address: City: Postal Code: Home # Cell # Work #E-Mail address:

Inspiration Station Preschool 2018 -2019 Registration

number to provide in an emergency.

Name: Relationship to Child: Address the same as child: Address: City: Postal Code: Home # Cell # Work #E-Mail address:

Yes No

Yes No

Emergency Contacts Please provide people to be contacted in case of emergency other than parents. We cannot accept box numbers as an address we must have a land description number to provide in an emergency.

Contact Name: _____________________________ Relationship to Child: ____________________

Address: ________________________________ City: ______________ Postal Code: __________

Home # __________________ Cell # ____________________ Work # ______________________

Alternate Pick Up People

Contact Name: __________________________________ Cell # ______________________ Contact Name: __________________________________ Cell # ______________________ Contact Name: __________________________________ Cell # ______________________

Background Information

Please check any of the following services (assessment and/or treatment) you have accessed on your child’s behalf - Including waitlists:

Speech Language Pathology Occupational Therapy Physical Therapy Psychology Vision Testing Hearing/ Audiology Early Childhood Development Team Other

If you checked any of the above, do you have any reports? Yes _____ No____ If your child is on a waitlist for any of the above services, please explain_______________________ _________________________________________________________________________________

Has your child attended any other preschools? Yes_______ No_____ If yes, where______________

Has your child received any services through Alberta Education? Yes____ No______ If yes, please describe: _________________________________________________________________________________ _________________________________________________________________________________

Do you have any concerns about your child’s development? Yes _____ No____ If yes, please describe: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

CHILDCARE LICENSING REGULATION Inspiration Station Preschool is not allowed to have a child in attendance with incomplete registration forms.

Inspiration Station Preschool

WEST EAST #1101- 403 Mackenzie Way SW, Airdrie #408, 2903 Kingsview Blvd SE, AirdriePhone: (403) 945-4561 Phone: (587) 775-7710

PLEASE INTRODUCE YOUR CHILD

My Child’s Name:_________________________Nicknames:________________________________ My child lives with: Both parents ____ only mom _______only dad _________ My child’s siblings: _________________________________________________________________________________ Our family has the following pets: ______________________________________________________ My child LOVES to: _________________________________________________________________ _________________________________________________________________________________ My child prefers to play: Alone? ___________________In groups? _________________________ What age children does your child typically play with? ____________________________________What is the method of behavior management used in your home? ________________________________________________________________________________________________________________________________________________________________ My child is toilet trained. Yes ___ No ___ Please describe assistance needed and any motivators being used: ________________________________________________________________________________ ________________________________________________________________________________

Does your child have any physical or emotional conditions that the staff should be aware of? Yes__ No___ If yes, please provide details: ________________________________________________________________________________ ______________________________________________________________________________

My child’s speech is clear? Yes ___ No___ Non-family members understand my child? Yes ___ No___ My child speaks the following languages ___________________________________ My child understands the following languages ______________________________

My child is: Happy Friendly Impulsive Fearful Quiet Anxious Compassionate Talkative Clumsy Attentive Physical Easy Going Independent Caring Shy Active Determined

What do you hope your child will gain from participating in a preschool program? ______________________________________________________________________________________________________________________________________________________________________________

Please contact the school throughout the year if there are any changes in your child’s life that we need to be aware of.

Consent Form CONSENT OF PARTICIPATION: I hereby give permission for my child to accompany his/her class, under the supervision of a preschool teacher, on outings during the preschool term. This includes outdoor play at the playground.

Signature of Parent/Guardian: __________________ Date: _______

PARENT’S AUTHORIZATION: My child has permission to engage in all prescribed Preschool activities. In the event that I cannot be reached in an EMERGENCY, I hereby give permission for my child to be hospitalized/treated as deemed necessary by medical personal.

Signature of Parent/Guardian: _________________ Date: ________

PLEDGE: I have read the information sheet and realize what will be required of me as a participating parent. I understand that it is my responsibility to read and abide by the Policies of the Preschool as outlined in the Preschool’s Parent Handbook provided on First Day of School. I agree to;

a) Pay fees promptly,b) Give thirty (30) days notice to the registrar before withdrawing my child,c) Abide by all school policies.

Signature of Parent/Guardian:__________________________Date: ________

TRANSPORTATION: Staff Affiliated with Inspiration Station Preschool are not in any way responsible for the safety of my child while being transported to and from Preschool. Staff of Inspiration Station, Airdrie Foundation 4 Early Intervention and Airdrie Connections 4 Early Intervention are NOT insured to transport children and are NOT approved to transport children.

Signature of Parent/Guardian: _________________ Date: ________

BEHAVIOUR POLICY:

It is central to the philosophy of the preschool that all staff should be very positive at all times towards the children, towards each other and towards the preschool. Any issues or problems arising with children, other members of staff or parents should be discussed in private with the director of the preschool. The passing of negative comments about parents, other staff or children is not acceptable in any other forum.

Our staff endeavour to implement positive behaviour strategies in order to teach children what behaviour we WANT rather than focusing on the behaviour we do NOT want.

Preschool children often do not have the ability to negotiate and verbally communicate their needs and/or concerns. Staff will endeavor to observe and interpret non-verbal communication and provide appropriate accommodations to support the child’s needs.

Please refer to our FULL Behaviour Policy posted in the coat room.

Signature of Parent/Guardian: _________________ Date: ________