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AKIDEMY Preschool - West Springs
Child Registration Form
Family
Family Name
First Parent
Relation to Child
First Name
Last Name
Cell Phone
Home Phone
Address
City
Province
AB
BC
MB
NB
NL
NT
NS
NU
PE
SK
ON
QC
YT
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
VI
WA
WV
WI
WY
Postal Code
Work Name
Work Phone
Work Address
Email Address
Second Parent
Relation to Child
First Name
Last Name
Cell Phone
Home Phone
Address
City
Province
AB
BC
MB
NB
NL
NT
NS
NU
PE
SK
ON
QC
YT
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
VI
WA
WV
WI
WY
Postal Code
Work Name
Work Phone
Work Address
Email Address
First Child
Given Name
Last Name
Goes By
Birthdate
Sex
Male
Female
Living Arrangements
Child lives with
Mother
Father
Other
Other Guardian
Is there a custody agreement?
No
Yes
Custody Agreement Notes
Enrolment
Desired Start Date
Room
M/W/F AM Preschool
T/TH AM Preschool
M/W/F PM Preschool
T/TH PM Preschool
M-F PM Preschool
Summer Camp
Frequency
Full Time
Part Time
Drop In
Hours
Days
Weeks
Months
per Hour
per Day
per Week
per Month
per Term
per Quarter
per Year
Medical
Diet Restrictions
Allergies
Other Medical Concerns
Is your child's immunization up to date?
No
Yes
Does your child receive medication on an ongoing basis?
No
Yes
Medication Details
Subsidy
Subsidy is approved
Amount Approved
I have applied for subsidy
Application Date
I will apply for subsidy
I need help applying for subsidy
I do not plan to apply for subsidy
Second Child
Given Name
Last Name
Goes By
Birthdate
Sex
Male
Female
Living Arrangements
Child lives with
Mother
Father
Other
Other Guardian
Is there a custody agreement?
No
Yes
Custody Agreement Notes
Enrolment
Desired Start Date
Room
M/W/F AM Preschool
T/TH AM Preschool
M/W/F PM Preschool
T/TH PM Preschool
M-F PM Preschool
Summer Camp
Frequency
Full Time
Part Time
Drop In
Hours
Days
Weeks
Months
per Hour
per Day
per Week
per Month
per Term
per Quarter
per Year
Medical
Diet Restrictions
Allergies
Other Medical Concerns
Is your child's immunization up to date?
No
Yes
Does your child receive medication on an ongoing basis?
No
Yes
Medication Details
Subsidy
Subsidy is approved
Amount Approved
I have applied for subsidy
Application Date
I will apply for subsidy
I need help applying for subsidy
I do not plan to apply for subsidy
Third Child
Given Name
Last Name
Goes By
Birthdate
Sex
Male
Female
Living Arrangements
Child lives with
Mother
Father
Other
Other Guardian
Is there a custody agreement?
No
Yes
Custody Agreement Notes
Enrolment
Desired Start Date
Room
M/W/F AM Preschool
T/TH AM Preschool
M/W/F PM Preschool
T/TH PM Preschool
M-F PM Preschool
Summer Camp
Frequency
Full Time
Part Time
Drop In
Hours
Days
Weeks
Months
per Hour
per Day
per Week
per Month
per Term
per Quarter
per Year
Medical
Diet Restrictions
Allergies
Other Medical Concerns
Is your child's immunization up to date?
No
Yes
Does your child receive medication on an ongoing basis?
No
Yes
Medication Details
Subsidy
Subsidy is approved
Amount Approved
I have applied for subsidy
Application Date
I will apply for subsidy
I need help applying for subsidy
I do not plan to apply for subsidy
Emergency Contacts
(Other than parents)
Relation to Child
First Name
Last Name
Cell Phone
Home Phone
Address
City
Province
AB
BC
MB
NB
NL
NT
NS
NU
PE
SK
ON
QC
YT
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
VI
WA
WV
WI
WY
Postal Code
Authorized for Pickup
Relation to Child
First Name
Last Name
Cell Phone
Home Phone
Address
City
Province
AB
BC
MB
NB
NL
NT
NS
NU
PE
SK
ON
QC
YT
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
VI
WA
WV
WI
WY
Postal Code
Authorized for Pickup
Agreements
Termination and Deposit Policy
The deposit provided is refundable for termination notice received prior to May 1, 2022 and will be directed towards the first month’s tuition. There is also a one-time yearly non-refundable registration fee, which helps provide high quality materials and art supplies.During the regular school calendar, one calendar month's notice must be given by either party to terminate this contract. Alternately in lieu of notice, the parent may pay one month’s fee.
Subsidy Policy
Preschool subsidy is available for any family with a household income under $180,000. If approved the applicable subsidy amount will be deducted from your fees. Applications can be made here: https://applychildcaresubsidy.alberta.ca/. Please forward your approval or conditional approval to tristan@akidemy.ca. I acknowledge that I am responsible for applying for subsidy, if required, and will be responsible for the full fee, until my subsidy is confirmed. I acknowledge that I am also responsible for renewing my subsidy on time and informing AKIDEMY of the approval by providing a copy of the approval. If subsidy is not approved by the first working day of the following month after expiring, I am be responsible for the full monthly child care fee. If subsidy is renewed/approved, the additional amount paid will be credited to your account.
Financial Policy
Monthly fees are required via pre-authorized debit on the first of each month. Refunds or adjustment will not be made for time missed, or planned closure dates such as statutory holidays and Professional Development Days. There is an NSF charge of $20 for each return/missed payment.Should payment(s) be missed, AKIDEMY will email and phone call to make payment arrangements. If two warnings are provided and no payment arrangements are made, further action could result in your account being sent to a collection agency.I recognize my financial obligation for paying the tuition fees stated and agree to abide by these stipulations.
Photographic Release
I consent and authorize AKIDEMY West Springs to use my child’s image in photographs/video for documentation purposes within the program, such as parent updates.
Medical Authorization
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 AKIDEMY to seek any medical treatment appropriate. I agree to be responsible for any costs incurred as a result of this medical treatment.
Parent Handbook Agreement
I acknowledge that I will be provided a copy of the AKIDEMY Parent Manual and agree to follow all policies outlined.
Wrap up
How did you first hear about us?
Print Directory
Alberta Government Website
Web Search
Word of Mouth (referral)
Drive by (saw the signs)
Other
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