Registration Form

Class Fees (Please select one)

3-year-old program
$100 per month$130 per month (non-duty)

4-year-old program
$160 per month$190 per month (non-duty)

** Spaces for non-duty option are limited **

Child's Name

Preferred Name

Date of Birth

Sex MALEFEMALE

Street Address

Town

Province
---ABBCMBNBNLNSNTNUONPEQCSKYT

Postal Code

Home Telephone

Email

Parent / Guardian 1

Work Tel #

Cell #

Parent / Guardian 2

Work Tel #

Cell #

EMERGENCY CONTACTS:

Name

Phone #

Name

Phone #

MEDICAL INFORMATION

Family Doctor

Phone #

Medicare Number

Allergies
List any allergies

Puffer, Epipen, or other? YESNO

PARENT/CAREGIVER OBLIGATION AGREEMENT

(1) To participate as a classroom assistant in my child's program on an equal rotation basis and to find a replacement if at any time I am unable to attend. Any further assistance in the classroom and on field trips is always welcomed and appreciated.

(2) In the event of withdrawing a child from the Rothesay Nursery School, written notice must be given to the Membership Coordinator one month in advance of the child's departure. All subsequent postdated cheques will be returned. Any cheques already deposited will not be refunded.

(3) To attend an orientation meeting prior to the start of the school year

(4) To assist with necessary cleaning to provide a pleasant and healthy environment for the children.

(5) To provide play dough (either homemade or purchased) on an equal rotation basis throughout the school year.

(6) To assist with fundraising events to help meet financial requirements.

(7) To read and adhere to the guidelines set out in the Parent Information Handbook.

(8) To update any changes to addresses, phone numbers, emergency contacts, or medical information.

(9) To provide for my child a healthy snack which according to provincial licensing requirements, includes 2 food groups. Drinks should be water, milk, or 100% juice.

(10) A copy of your child's Immunizations Record (or a Waiver) will be required the first week of school

Your dedication and involvement are CRITICAL to the operations of the school and significantly enhance the children's experience at RNS.

Please indicate the areas in which you can participate:

Executive BoardExtra Duty DaysFundraisingOther

A $50.00 non-refunable Registration fee must be paid to guarantee registration; this registration fee also includes a cost for field trips throughout the school year.

Please send a $50.00 e-transfer to RothesayNurserySchool@gmail.com

We require 10 post-dated cheques for the payment of monthly fees:
- The first month's cheque should be post-dated for August 1. The remainder should be post-dated for Oct 1, Nov 1, Dec 1, Jan 1, Feb 1, Mar 1, Apr 1, May 1, and Jun 1
- Registration is not complete until your cheques are received by the school.
- Email Money Transfers are Accepted

I've read and agree to the terms under the Parent Agreement

PARENT'S SIGNATURE
DATE