Summer Preschool Academy Registration 2023 (Bridlewood)

IMPORTANT INFORMATION

CHILD MUST BE TOILET TRAINED AND THREE (3) YEARS OLD BY JUNE 30, 2023.
FEES MUST BE PAID IN FULL AT THE TIME OF REGISTRATION BY eTRANSFER TO admin@learningexperience.ca
NAME OF CHILD AND SUMMER PRESCHOOL ACADEMY MUST BE STATED ON THE eTRANSFER.

CANCELLATION POLICY

FAMILY CANCELLATION: Parents may cancel up to 7 days prior to the start of class for a full tuition refund. The Registration fee is non-refundable.
LEARNING EXPERIENCE CANCELLATION: Classes may be cancelled up to 7 days prior to the start of class and Parents will be refunded the full tuition and registration fee.

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 *

SUMMER PRESCHOOL ACADEMY DAYS, TIMES AND TUITION FEES

Three (3) Days per week
Tuesday/Wednesday/Thursday
Class Time 09:30 - 12:30
Registration Fee $25.00 (per family/one time only)
$240.00 for three weeks per month
$160.00 for two weeks per month
$80.00 for one week per month

Please check the week(s) you would like your child to attend *

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

OUTDOOR PLAY AND ACTIVITY CONSENT; PAYMENT AGREEMENT

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. *

Agree

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

I/We acknowledge that my/our child's spot at Learning Experience Summer Preschool Academy is not confirmed or guaranteed until the eTransfer has been received. *

Agree

Signature *

Date *

Signature

Date

Email to send Confirmation of Registration *