Registration Form

Highwood Playschool

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Welcome to Highwood Playschool ...

where children learn and develop naturally

in an inspiring and nurturing environment

Registration Index 2010-2011

Please note that all of the following registration requirements must be met to reserve a space for your child. Please complete the checklist and submit all forms to the Registrar at the Playschool or call Lia at 403-697-2864 to make other arrangements.

Read the philosophies and policies of Highwood Playschool as posted on this website.
Complete the Registration Form; no spaces left blank or questions unanswered.
Attach the necessary post-dated cheques payable to Highwood Playschool Association:

Non-refundable Registration Fee of $50.00 ($35 Administration fee + $15 Highwood Membership fee), today's date.
Monthly Tuition Fees of $100.00 for 3 y.o. class/ $150.00 for M/W/F class; dated Sept 1, Oct 1, Nov 1, Dec 1, of 2010 and Jan 1, Feb1, Mar 1, Apr 1, May 1, Jun 1, of 2011.
Work-Bee Deposit of $100.00, dated January 1 2011, refundable.
Fundraising Deposit of $100.00, dated April 1 2011, refundable.

**Please take note of these Payment Details:

Checks are to be made payable to Highwood Playschool. There will be a $25.00 fine for any NSF checks. During the year, one month's written withdrawal notice must be provided to the registrar to secure a refund for the remaining portion of the year. There can be no refund for tuition due to vacation, holidays or illnesses. The total tuition for the year is divided into 10 equal monthly payments, regardless of total class-days in each month.

To Use this Registration Form, please "copy and paste" the following text to a document on your computer, and then print.

To arrange to submit your registration package, please call Lia at (403) 697-2864.

HIGHWOOD PLAYSCHOOL REGISTRATION FORM, 2010-2011

Child's Full Name:_______________________ Sex:__________

Given Name to be used in Playschool:___________________

Language most used at home:________________

Birthdate: _____________ Age, as of Sept 1st, 2010:_____

Address with postal code:____________________________________

Family e-mail address:

Parent/Guardian #1: Full Name:________________________ Occupation:_______________________

Address (if different from child's):_____________________________________

Home Phone:_______________ Work/Cell Phone:_______________

Parent/Guardian #2: Full Name:_________________________ Occupation:_______________________

Address (if different from child's):_____________________________________

Home Phone:_______________ Work/Cell Phone:________________

Siblings names and ages:_____________________________________________

Emergency Contacts (required by Licensing Office, must be other than parents):

Name #1:__________________________ Relationship to child:____________

Adress: Phone:

Name #2: __________________________ Relationship to child:____________

Adress: Phone:

These emergency contact people also have permission to pick up child from school.

Child's Medical Information?

1. List any allergies and treatments (i.e., Epi-pen, Benadryl):



Note: An extra supply of you child’s medications/treatments must be provided to the Plasychool on the 1^st day of school along with a current photo of your child. You must also complete a Severe Allergies Form.

2. Immunizations:                   up-to-date                  not up-to-date                  not completed

Note: If your child contracts the measles, Alberta Health Services requires that they remain out of any group activities for 3 weeks following the end of the disease.

3. Please list your child’s medications taken on a regular basis?

Note: If you require the Plasychool to administer any medication dosage for allergy, asthma, or medical condition in case of emergency ONLY, you must sign a permission slip acknowledging this.

4. Special Diet for health/religious reasons:

Note: If your child has any life threatening food allergies, you are required to provide your child a backup snack to be kept at the school.

5. What kinds of things is this child interested in? What is he/she good at?





6. Previous group experiences:

7. Please identify any special concerns, fears, or needs:



o Does anyone in your family have any special interests or skills that might be shared to enrich the playschool?

o How did you hear about Highwood Playschool?

I, the guardian of   , have read and agree to support the philosophies, policies and procedures of the Highwood Playschool and release the Highwood Playschool Association from any liability included but not limited to an injury, illness or allergic reaction at the Playschool.

Signature of Guardian:                                                                Date: