Registration

First Parent

Relation to Child

First Name

Last Name

Cell Phone

Home Phone

Address

City

Province

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

Postal Code

Work Name

Work Phone

Work Address

Email Address

First Child

Second Child

Third Child

Emergency Contacts (Other than parents)

Relation to Child

First Name

Last Name

Cell Phone

Home Phone

Address

City

Province

Postal Code

Authorized for Pickup

Relation to Child

First Name

Last Name

Cell Phone

Home Phone

Address

City

Province

Postal Code

Authorized for Pickup

Agreements

Photos Inside the Centre

I hereby consent to and authorize Daisies Academy to use and reproduce photographs taken of my child to post inside the centre.

Photos for Online Media

I hereby consent to and authorize Daisies Academy 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 Daisies Academy and I hereby give consent for my child to participate in these activities, without additional notifications for such walks.

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?

Web Search

Word of Mouth (referral)

Drive by (saw the signs)

Other