Preschool Registration Form (Page 3 of 4) in pdf

Please list any physical restrictions, allergies, or health concerns of the student that the school should be aware of:

_________________________________________________________________________________________________

Mild

Moderate

Life Threatening

What medication does the student require?

____________________

Doctor:

Phone

Care Card

________________________________

(______) __________________

__________________________

Are there any indications that your child may have vision or hearing loss

Yes

___________________

Has your child received services from the Child Development Centre? If yes, please describe

_________________________________________________________________________________________________

Is there any other information that would be helpful for us to know e.g., behavior, speech, special diet

_________________________________________________________________________________________________

Please indicate your preferences for your child’s program. Note: we may not be able to accommodate all requests

3 year old, Tuesday and Thursday mornings

4 year old, Tuesday and Thursday afternoons

4 year old, Monday, Wednesday and Friday mornings

4 year old, Monday, Wednesday and Friday afternoons

The MEI Preschool Phone Directory will be prepared and distributed to your child’s preschool class only.

May we publish your phone number and address in the MEI Preschool Phone Directory

Yes

How did you hear about MEI?

Friend/Family

Newspaper

Church

MEI Website

School Tour

Other: ____________

Is the parent(s) an alumnus of MEI?

Mother

Class of: ____________

Maiden Name: ___________________

Father

Class of: ____________

Protecting Your Personal Information

MEI gathers and uses personal information to provide your child with the best educational services as outlined in our Mission Statement and core values. The

personal information on this form is required in order to register your child at MEI and assist the school authority in making informed decisions on the suitability and

appropriate placement of your child. This information will also allow MEI to respond immediately to an emergency. MEI commits to using and storing this information

responsibly and will not release this information to a third party without your verbal or written consent, unless permitted under the PIPA (Personal Information Privacy

Act) legislation. MEI does not sell, lease or trade information about you to other parties. For more information on MEI’s use, storage and disclosure of personal

information, please contact the privacy officer for MEI Schools.

Your signature:

♦ Confirms that all information given is accurate and you agree to comply with MEI’s learning objectives, behavioral

expectations and internet use policy.

♦ Gives consent to call a medical practitioner or ambulance in case of accident or illness if the parent cannot immediately be

reached.

♦ Confirms that you have read and understood MEI’s Tuition Policies and agree to pay all tuition fees and other financial obligations

for your child to MEI Schools in keeping with these policies.

♦ Gives consent for your child to participate in all preschool field trips, including those on the MEI Campus.

♦ Acknowledges that photos of your child may be used by MEI for yearbooks, newsletters and other promotional materials.

♦ Gives consent to having MEI collect, use and disclose the personal information on this form as outlined above and defined

in Policy 7620

_________________________________________________

_________________________________________

PARENT / LEGAL GUARDIAN SIGNATURE

PARENT / LEGAL GUARDIAN NAME PRINTED

_________________________________________________

DATE

A registration fee of $40 is required to accompany all registrations, refundable only in the event we are unable to enroll your

student and the student does not remain on the wait list. A current photograph of your child, the MEI Preschool

Immunization Record, the Emergency/Disaster Form and copies of the student’s Birth Certificate and Care Card are

also required. A Tuition payment is due September 1, 2016.

For Office Use Only

Date Received: ______________________________

Registration Fee: ____________________________

Birth Certificate

Care Card

Receipt #: _______ -

Photo of Child

Immunization / Emergency Consent Form

Preschool Registration Form Page 3

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