Register

Community League Number *

All registering families must be a member of a community league in Edmonton.

Fee Information:

Each registrant will provide the following cheques:

Bingo/Casino Deposit ($300, signed but undated)
Volunteer Deposit ($100, signed but undated)

Fees Include:

Registration Fee ($100 for new families, $50 for returning families)
Monthly Fees (automatic withdrawal on 1st of month)
Cleaning Fees (2 payments of $25, automatic withdrawal in September and February)

Choose a Class: (select one only) *

Bumblebees (3 yr old class, T/Th 9-11:30, $130 monthly) Caterpillars (4 yr old class, M/W/F 9-11:30, $150 monthly Fireflies (4 yr old class, M/W/F 12:30-3 pm, $150 monthly)

Choose Registration Status: (select one only) *

New Family (no previous children in the program) Returning Family (previous children have attended)

Child's Information:

Child First Name: *

Child Middle Name: *

Child Last Name: *

Gender *

Birth Date *

# of Siblings *

Ages of Siblings *

Home Address:

Street Address: *

City *

Province *

Postal Code *

Parent/Guardian Information:

Parent/Guardian First Name: *

Last Name: *

Main Phone # Number: *

Relationship to Child: *

Email *

Occupation *

Address Information:

Address: *

Lives with child at address above Does not live with child (enter address below)

Please specify any special custody or access arrangements:

Street Address: *

City *

Province *

Postal Code *

Parent/Guardian Information #2:

Parent/Guardian #2 First Name: *

Last Name: *

Main Phone # Number: *

Relationship to Child: *

Email: *

Occupation: *

Address Information:

Address *

Lives with child at address above Does not live with child (enter address below)

Please specify any special custody or access arrangements:

Street Address: *

City *

Province *

Postal Code *

Other persons authorized for pick up/emergency contacts:

Full Name: Other persons authorized for pick up/emergency contacts

Relationship to Child:

Cell Phone # Number:

Relevant Medical History:

AB Healthcare #: *

Family Physician: *

Family Physician Phone # Number *

Are Immunization up to date? *

Yes No

Please list any allergies, emergency or daily medications, previous surgeries, areas of concern regarding health or development, or other relevant information:

Parent Agreement:

By clicking “I Agree”, Parents/Guardians are agreeing that they are aware and consent to the following conditions:

I understand that the $100 registration fee is non-refundable under any circumstances.($50 for returning children). I understand that the $50 cleaning fee is non-refundable ($25 Sept 1, 2018, $25 February 1/2019)

Registration & Cleaning Fee

I AGREE

In the event that I choose to withdraw my child from the playschool before the end of the school year, I agree to provide one month written notice. Should I not provide sufficient notice, I understand I am responsible for the following month’s tuition fee via automatic withdrawal. I also understand that upon withdrawal, it is my responsible to ensure my Bingo/Casino commitment and Volunteer commitment are completed. I understand the Playschool will deposit my Bingo/Casino check ($300) and/or my Volunteer check ($100) if the respective requirements have not been completed.

Notice of Withdrawal

I AGREE

I have read and I understand the Operations Policy and agree to comply with the Playschool requirements.

Operations Policy

I AGREE

I have reviewed the Photography Policy in the WEPS Policy document and agree to comply with this policy, in order to protect the privacy of all children enrolled in WEPS.

Photography Releases

I AGREE

I give permission for my child to be taken outside to the playground area and park next to the Lynnwood Community Hall and walks for supervised play and discovery while in attendance at West Edmonton Playschool. Outside play is weather permitting.

Outside Play Release

I AGREE

I understand that West Edmonton Playschool generates a large portion of funding through Casino (even years), Bingo, and other Fundraising activities. I understand my obligation to provide one person to represent my child at each of the mandatory Bingo/Casino events. I understand the Playschool will deposit my Bingo/Casino check ($300) if I do not fulfill these requirements.

Bingo/Casino

I AGREE

I understand that the playschool relies on our families to continue to operate effectively. As such, I will be required to volunteer on a committee or to take a position on the executive board. I have provided a deposit for $100 that will be returned to me once I have completed my responsibility.

Parent Committee

I AGREE

In the event of a medical emergency, appropriate health care will be provided and parents/guardians as well as the family doctor will be notified at once. The child may require transportation to the nearest medical facility; this may be by car or by ambulance. Any costs incurred by such transportation will be paid by the parent(s) or legal guardian.

Emergency Transportation

I AGREE

I give permission for my name, my child’s name, my email and phone number to be used for playschool purposes only.

Privacy Release

I AGREE

How did you hear about our Program? *

Parent Agreement:

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