Child Care Registration (Bridlewood) Summer 2023

IMPORTANT INFORMATION

JULY 3, 2023 - AUGUST 31, 2023
MONDAY - FRIDAY 07:30 - 17:30
CHILD MUST BE THREE (3) YEARS OLD ON JUNE 30, 2023 AND MUST BE TOILET TRAINED
SUMMER CHILD CARE WILL BE OFFERED BASED ON ENROLLMENT
CHILD CARE TUITION TO BE PAID ON THE 1ST OF EACH MONTH BY HIMAMA AUTOPAY
SNACKS AND LUNCH TO BE PROVIDED BY PARENTS/GUARDIANS
$25.00 DEPOSIT WAIVED FOR CURRENT PRESCHOOL/CHILD CARE FAMILIES

CHILD CARE DAY PASS

$80.00 per day
Cancellations must be a minimum of 24 hours in advance to receive refund
Must be used by August 31, 2023
Non-refundable and non-transferable
eTransfer payment to admin@learningexperience.ca with the name of the child added

*** LEARNING EXPERIENCE RESERVES THE RIGHT TO CANCEL OR MODIFY CLASSES BASED ON ENROLLMENT. IF A CLASS IS CANCELLED, ALL FEES WILL BE FULLY REFUNDED.

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 *

*** Tuition has been reduced by the Government of Alberta’s Affordability Grant (AG). If this Grant is changed or withdrawn by the government at any time during the months of July and August 2023, the monthly tuition will increase by the amount of the grant. ***

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 If this Grant is withdrawn by the government at any time during the school year, the monthly tuition will increase by the amount of the grant. ***

Child Care Hours : 07:30 - 17:30

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)

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 tuition 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 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 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 I have paid the Tuition fees for July 2023 and the aforementioned financial and fee conditions have been provided. *

Agree

Signature *

Date *

Signature

Date

Email to send Confirmation of Registration *