seedsandsprouts.edm@gmail.com
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780-757-7333
Seeds & Sprouts Early Learning and Childcare Centres Global
Online Registration
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
Birthdate
Email Address
By providing your email address you are implying consent to receive occassional email messages from our centre
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
Birthdate
Email Address
By providing your email address you are implying consent to receive occassional email messages from our centre
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
Program
Daycare
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
Health Care #
Physician's Name
Physician's Phone
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
Other questions, comments or notes
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
Program
Daycare
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
Health Care #
Physician's Name
Physician's Phone
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
Other questions, comments or notes
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
Program
Daycare
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
Health Care #
Physician's Name
Physician's Phone
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
Other questions, comments or notes
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
Sunscreen Application
I hereby authorize Seeds & Sprouts Early Learning and Childcare Centres Global staff to apply sunscreen (provided by parents) on my child in spring and summer as needed.
Health And Wellness Policy
I have read and understood the Illness Policy that it is the Parent Handbook. I agree to abide by the standard that is set out by Alberta Heath, and I understand that Seeds & Sprouts ELCC also abides by this standard.
Parent Handbook
I have read and understood the Parent Handbook that was provided to me, and agree to the terms that are set out within it.
Insect Repellent Application
I hereby authorize Seeds & Sprouts Early Learning and Childcare Centres Global staff to apply insect repellent (provided by parents) on my child in spring and summer as needed.
Photos Inside the Centre
I hereby consent to and authorize Seeds & Sprouts Early Learning and Childcare Centres Global to use and reproduce photographs taken of my child to post inside the centre.
Photos for Online Media
I hereby consent to and authorize Seeds & Sprouts Early Learning and Childcare Centres Global to use and reproduce photographs taken of my child to use for display on our website and any online social media platform.
Neighbourhood Walks
I understand that walks to neighbourhood areas and parks are part of the programming at Seeds & Sprouts Early Learning and Childcare Centres Global and I hereby give consent for my child to participate in these activities, without additional notifications for such walks.
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 Seeds & Sprouts Early Learning and Childcare Centres Global to seek any medical treatment appropriate. I agree to be responsible for any costs incurred as a result of this medical treatment.
Transportation to and from School
I hereby consent and authorize Seeds & Sprouts Early Learning and Childcare Centres Global to walk my child to/from school, supervised by the Director and/or staff of Seeds & Sprouts Early Learning and Childcare Centres Global.
Telephone Number Release
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.
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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