KENTON PRESCHOOL PROGRAMS, REGISTRATION FORM - DOC by pr3GG4

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									MY FIRST PRESCHOOL PROGRAMS, REGISTRATION FORM
                                               * PEANUT FREE PROGRAMS *


Please print, fill in full and return/mail :                        List (name/relationship) who can pick up your child

    My First Preschool Programs
                                                    1. _______________________________
    7 Edithvale Dr. Room 219                        2. _______________________________
    Toronto, M2N 2R4
                                                    3. _______________________________

Registration Fee: There is a $50 registration fee per child per year for My First Nursery Co-op and Reading & Math
Parade programs only. The registration fee for a second child in the same family is $25. Registration fee is non-
refundable. Please make all cheques payable to KENTON TINY TOTS.

Cancellation Fee: Once a session has started, no refunds will be given unless the program is full and your spot has been
filled. Refund Requests received in writing 4 weeks before commencement of a new session will be honored, but will not
include the $50 registration fee. Please note that no compensation will be made for unexpected cancellation of classes
and for closure due to Statutory or other legal holidays when the building will be closed.

PLEASE CHECK THE PROGRAM(S) FOR WHICH YOU ARE REGISTERING YOUR CHILD:

o MY FIRST NURSERY CO-OP:
  Mon.__    Tues.__ Wed.__             Thurs.__ Fri.__ Three (3) post dated cheques, one for each term, dated 4 weeks
    before the first day of each term are required with this registration form. Calculate fees according to chart:
                                 st                          nd                         rd
                                1 term (15 weeks)        2        Term (12 weeks)      3 Term (12 weeks)
                                                                                                                    Daily Fee
                                  Sept. to Dec.                   Jan. to March          April to June
      5 mornings/week                 $1,110                         $870                    $885                    $15.00
      4 mornings/week                  $900                          $720                    $720                    $15.00
      3 mornings/week                  $675                          $546                    $546                    $15.00

o SUMMER CAMP: for June 1 , to cover the entire fee $840 for 6 weeks ($28 per day) or $150 per week ($30 per
  One post-dated check
                                          st

    day) or $31 per day if registering 3-4days per week. Please indicate on a separate sheet for which weeks and days
    you are registering.

o LUNCHeach lunch time 12:00 am to 1:00pm, on Alphabet Parade days only.
  $6 per
         PROGRAMS:


CHILD'S NAME: __________________________________________________________ AGE : __________________

Birth Date: Date __________________Month ________________Year _____________ Sex: M ________ F__________

Parents' Names: Mother _________________________________ Father ____________________________________

Home Address: ________________________________________________________ Postal Code _________________

Home Phone __________________ Business Phone : ___________________ Cell Phone:______________________

e-mail address ____________________________________________________________________________________

IN CASE OF EMERGENCY:

1. First Name__________________________ Last Name____________________ Relationship to Child _____________

  Home Phone _________________________________ Business Phone ___________________________________

2. First Name_________________________ Last Name____________________ Relationship to Child______________

  Home Phone___________________________                             Business Phone______________________________________

  Doctor's Name____________________ Phone # ___________________


SPECIAL INFORMATION OR INSTRUCTIONS (Allergies, food requests, special needs)
_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________
                At the discretion of the staff and parent committee, a child may be requested to leave the program,
                                           if the program is not able to meet his/her needs.



LIABILITY STATEMENT I recognize that risk of injury or potential health risk may be involved in participation in the above
mentioned programs/activities. I hereby willingly assume such risk for myself and for the above mentioned person(s) for
whom I am in law responsible and for my representative who may do a duty day and assume full responsibility during and
after my/their participation in the programs/activities. I, for heirs' executor's administrator successors assigns and myself
HEREBY RELEASE, WAIVE and FOREVER DISCHARGE the City of Toronto and My First Preschool staff, Parent's
Committee, all other organizations, associates and employees, officials, servants, contacts, representatives elected and
appointed officials, successors and assigns OF AND FROM ALL claims, demands, damages, costs and actions and
actions whatsoever caused, arising or to arise by reason of my/their participation in the program or any of its associated
activities. I further authorize My First Pre-school Parents' Committee and staff to obtain such medical care to the person
listed above, myself or a representative who is on duty, as it may deem necessary in the event of injury or otherwise, and
agree to pay for all expenses incurred.



Signature of Parent or Guardian________________________________________                    Date______________________

								
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