Family
First Parent
Second Parent
First Child
Living Arrangements
School
Please enter school details as you expect them to be on your child's start date
Enrolment
Medical
Subsidy

Second Child
Living Arrangements
School
Please enter school details as you expect them to be on your child's start date
Enrolment
Medical
Subsidy

Third Child
Living Arrangements
School
Please enter school details as you expect them to be on your child's start date
Enrolment
Medical
Subsidy

Emergency Contacts (Other than parents)


Agreements
I agree that I will be the one to provide booster/car seat to Dickinsfield Child Development Centre for school pick-up and drop-offs.
I authorize Dickensfield Child Development Centre staff to observe and apply on my child the Nippising for development
I hereby consent to and authorize Dickensfield Child Development Centre to use and reproduce photographs taken of my child to circulate same for advertising and display purposes of every description
I hereby authorize Dickensfield Child Development Centre staff to apply sunscreen on my child in spring and summer as needed.
I hereby authorize Dickensfield Child Development Centre staff to apply insect repellent on my child in spring and summer as needed.
I hereby consent to and authorize Dickensfield Child Development Centre to use and reproduce photographs taken of my child to circulate same for advertising and display purposes of every description
I understand that field trips and walks to neighbourhood areas and parks are part of the programming at Dickensfield Child Development Centre and I hereby give consent for my child to participate in these activities.
In the event that I can not be reached and emergency medical treatment is required for my child, I hereby agree to allow the Director or staff of Dickensfield Child Development Centre to seek any medical treatment appropriate. I agree to be responsible for any costs incurred as a result of this medical treatment.
Other parents sometimes request a family's phone number so they can phone to invite your child to a birthday party or some other social event. Please sign below if you have no objections to the release of your phone number for this purpose.
This is to agree that Dickinsfield Child Development Centre and Alberta Childrens Services is required to share information
I agree to the policies and procedures of Dickinsfield Child Development centre as outlined in the Parent handbook / registration forms and agree to abide by them
Wrap up
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