Child Care Registration (Bridlewood) 2023-2024

CHILD INFORMATION

Name of Child *

First

Last

Date of Birth *

Sex *

Male
Female

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

CLASS TIMES/OPTIONS AND MONTHLY TUITION

*** Tuition has been reduced by the Government of Alberta’s Affordability Grant (AG). If this Grant is withdrawn by the government at any time during the school year, the monthly tuition will increase by the amount of the grant. ***

*** CLASSES START AFTER THE LABOUR DAY WEEKEND ***

Child Care Hours : 07:30 - 17:30 (Should align with all or some of child’s preschool days ) (Subject to availability)

5 Days (100+ hours per month) ($453.00 per month) (AG $450.00 per month)
3 Days (50 - 99 hours per month) ($387.00 per month) (AG $225.00 per month)
2 Days (50 - 99 hours per month) ($185.00 per month) (AG $225.00 per month)

Preferred Start Date *

CONSENT FOR PHOTOGRAPHS

I/We consent to photos being taken of our child by their classroom teacher during classroom activities and being shared on HiMama with me/us and other parents in my/our child's class if a group photo is taken.

Consent
Do not Consent

PARENT/GUARDIAN INFORMATION (PLEASE COMPLETE ALL INFORMATION FOR BOTH PARENTS/GUARDIANS)

Parent/Guardian Name *

First

Last

Relationship to Child *

Cell Phone *

Email *

Parent/Guardian Name

First

Last

Relationship to Child

Cell Phone

Email

Are both Parents/Guardians authorized to pick the child up from Learning Experience? *

Yes
No

If NO, please provide details.

Is a custody order in place? *

Yes
No

If YES, please provide details.

EMERGENCY CONTACT INFORMATION

(NOT LIVING WITH THE CHILD AND TWO EMERGENCY CONTACTS REQUIRED)

Emergency Contact *

First

Last

Relationship to Child *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone (Cell phone preferred) *

Emergency Contact *

First

Last

Relationship to Child *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone (Cell phone preferred) *

ADULT(S) AUTHORISED TO PICK CHILD UP

Adult authorised to pick child up from Learning Experience (other than Parent/Guardian/Emergency Contact)

First

Last

Relationship to Child

Phone (Cell phone preferred)

Adult authorised to pick child up from Learning Experience (other than Parent/Guardian/Emergency Contact)

First

Last

Relationship to Child

Phone (Cell phone preferred)

MEDICAL INFORMATION

Name of Family Doctor *

First

Last

Phone *

Alberta Health Care # *

Does the child have any allergies? *

Yes
No

If YES, please provide details.

Does the child have any food sensitivities? *

Yes
No

If YES, please provide details.

Does the child have any dietary restrictions? *

Yes
No

If YES, please provide details.

The child’s immunizations are up to date? *

Yes
No

Please provide any further information about your child.

OUTDOOR PLAY AND ACTIVITY CONSENT

Learning Experience has an outdoor space used as play space for the children attending the preschool. During the year, outdoor play may also include walks in the community. Parents and caregivers will be informed if outdoor play involves a community walk.

As the parent(s)/guardian(s) of the above named child, I/We give permission for my/our child to participate in Learning Experience outdoor play and/or activities and/or outings. *

Yes
No

I/We release Learning Experience Limited and/or their staff from any liability that may arise out of outdoor play and/or activities and/or outings with my/our child. While every effort will be made to ensure my/our child's safety, I/We will not hold Learning Experience Limited and/or their staff liable for any accident or other event that may occur during outdoor play, activities and/or outings. *

Agree
Do Not Agree

AUTOMATIC FEE PAYMENT; FEES AND TERMINATION POLICIES

Learning Experience uses HiMama for billing and the payment of preschool fees.

I/We, the Payor, agree to set up my/our banking details with HiMama when the activation is received. *

Agree

I/We, the Payor, agree to select the AUTOPAY option when setting up my/our account with HiMama. *

Agree

I/We, the Payor, may revoke my/our authorization at any time by giving the Payee, Learning Experience Limited thirty (30) days prior written notice. Such written notice must be provided to Learning Experience Limited by email. *

Agree

I/We shall inform the Payee, Learning Experience Limited, in a timely manner, of any changes to my banking details. *

Agree

I/We agree to pay the non-refundable, mandatory administration fee of $55.00; and tuition fees for June of the current school year (both due on date of registration) via eTransfer to admin@learningexperience.ca to confirm my/our child's spot. *

Agree

I/We agree that preschool or child care withdrawal notices for September programs must be submitted to the office by August 1st. *

Agree

I/We agree that a minimum of one (1) calendar month’s written notice of withdrawal is required on or before the 1st of the month prior to the month leaving (e.g. September 1 if leaving in October). *

Agree

I/We agree that the deposit (June tuition) may be used to pay for the withdrawal month’s tuition if appropriate notice is provided. *

Agree

I/We agree that monthly tuition will not be prorated for any reason and that there will be no refunds for missed days unless due to a province-wide closure. *

Agree

I/We agree that temporary absences, such as a vacation or illness, will not be deducted from the monthly tuition due. *

Agree

I/We agree that a $40.00 NSF fee will be added to any NSF payment. Payment in cash or certified cheque will be required for that payment (or as arranged with Administration). *

Agree

I/We acknowledge that my/our child's spot at Learning Experience is not confirmed or guaranteed until the aforementioned financial and fee conditions have been provided. *

Agree

I/We acknowledge that this registration period is for the 2023-2024 Academic Year. *

Agree

Signature *

Date *

Signature

Date

Email to send Confirmation of Registration *