We encourage you to add your name to our wait list as early as possible to increase the chances of
securing a spot. To be added to our wait list, complete the Pre-Registration Form below:
SECTION 1
A. CHILD’S INFORMATION
B. GUARDIAN INFORMATION/MOTHER
Mother/Guardian
Occupation
Employed by
Work Address
Working Hours
Home Address
Postal Code
Work Phone #
Cell Phone #
Home Phone #
Email Address
Marital Status
C. GUARDIAN INFORMATION/FATHER
Father / Guardian
Occupation
Employed By
Work Address
Working Hours
Home Address
Postal Code
Work Phone#
Cell Phone #
Home Phone #
Email Address
Marital Status
D. ALTERNATE EMERGENCY CONTACT
Name
Phone
Relation to child
Work Phone #
Address
Can pick all children in the family?
Codeword to be used by persons picking up your child
E. HEALTH INFORMATION
Alberta Health Care Number
Doctor’s Name
Telephone
Address
Immunization is updated:
F. CHILDHOOD ILLNESS
Allergies: (Specify)
Other Dietary restrictions
Childhood Illness (if any)
Hospitalization: (Date and Diagnosis)
Has your child had any medical or condition requiring or receiving treatment or supervision?:
If yes please describe
Is your child on ongoing medication?
If yes what kind?
SECTION 2
A. PERMISSIONS AND ACKNOWLEDGEMENTS
To grant permission, in case of accident or illness, that emergency care be given, including emergency transportation ( if necessary in Webber Greens judgment), at my own expense.
To give one month notice of withdrawal.
To pay daycare fees in advance on or before the 1st working day of each month. I
understand late payments are subject to a late payment penalty of $5 per day.
To have my child picked up by 6:00 P.M each evening or to pay the LATE PICK UP CHARGE of $ 1.00 for each minute per child after 6:00 that my child or children remains in the center’s care.
Webber Greens has my permission to take my child on field trips under supervised
care:
Yes No
That I have read and understand all information in the parent handbook and that I was
given a tour:
Yes
No
Orientation process (director explained all policies and procedures and gave a tour of the facility) is
completed by the director:
Yes
No
B. FOR DIRECTOR’S USE
Today’s Date
Commencement Date
Withdrawal Date
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When you are offered a spot at our daycare, you will meet with the daycare’s director, receive a tour, go
over our policies and have an opportunity to ask the questions.
Your child’s enrolment at the centre will be completed after making a payment of first month’s fees along
with one-time registration fee of $40.00 per child (non-refundable).
