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Shawkwunlee Daycare Registration

Shawkwunlee Daycare Registration

Child Information:
Name
Address
DD slash MM slash YYYY
Gender:
DD slash MM slash YYYY
CAFN Citizen
CAFN Staff member
Parent-Guardian 1 Information Name:
Name
Address
Parent-Guardian 2 Information Name:
Name
Address

Authorized Pick Up List Person must be 19 years of age or older and I authorize the following people: (In addition to the Parent/Guardian 1 & 2 information) already listed on page 1) to pick up my child and/or be contacted in case of emergency

Contact #1
Name
Address
Contact #2
Name
Address
Contact #3
Name
Address

The Following People are NOT Authorised to pick up my child

Please note that we will ONLY release a child to the people LISTED on this form/emergency permission card. A child will only be released to people not listed, when a staff has received WRITTEN OR VERBAL CONSENT FROM THE PARENT/GUARDIAN confirming that the person is permitted to take the child PRIOR to pick up.

HEALTH INFORMATION:
Family Doctor name
Are your child’s immunisations up to date?
Does your child have any allergies?
Does your child have any health or medical issues such as Special medications, Vision Hearing, Speech/Language, Require a special diet or Other?

For medication to be administered at the centre, you must request the required medication consent forms

Social and Behavior information

When filling out this section we encourage parents to give us as much information as possible. Knowing about your child’s social and behaviour requirements before hand allows us to take a proactive approach to their individual needs and therefore help to ensure that they are successful and enjoy the program.

Display signs of anxiety in a group of children?
Require assistance dressing?
Require assistance toileting?
Require assistance feeding?
Behaviour Issues?
Does your child have any fears?
Does your child have any difficulties sleeping/or a special routine?
Field Trips
Consent
Clear Signature
Clear Signature
DD slash MM slash YYYY
Photos and Videos
I give permission for Photographs and videos of my child to be used in publicity in which the program participates ( ie.. Newsletters for daycare and CAFN as well as the web pages for daycare and CAFN)
Clear Signature
Clear Signature
DD slash MM slash YYYY
Medical Consent

It is the Child Care’s policy to notify a parent when a child is ill or in need of medical attention. Occasionally we are unable to contact parents and we need to get immediate help for the child. Our procedure is to have the child taken to the nearest emergency service by ambulance If an ambulance is not available, the caregiver/staff of the childcare will transport the child.

Consent
Clear Signature
Clear Signature
DD slash MM slash YYYY

Policy Agreement between Shawkwunlee Daycare & Parent/Guardian

Consent
Clear Signature
DD slash MM slash YYYY
Clear Signature
DD slash MM slash YYYY