The Cridge Day Care Registration Form - Extended

This program is available to children from 30 months up to 5 years of age. Please note that a deposit is not required to occupy the space on a waitlist. When the offer of an available spot is accepted, a deposit of $100 must be paid to guarantee the space. No spaces are guaranteed until the deposit is received and enrollment is confirmed by the management. The deposit will be held in the trust to be applied to your last month’s fees. A $15 payment for the mandatory Earthquake Kit is also required. After space has been accepted by the parent/guardian if the child is subsequently withdrawn a 15% administration fee will be withheld from the deposit. The remaining balance will be refunded if 4 week’s notice is provided. If the notice is less than 4 weeks there will be no refund. The Cridge Child Care management reserves the right to determine child and program compatibility.

The Cridge Centre for the Family collects personal information on this form for reasonable and obvious purposes such as verifying identity, enrolling in service, securing contact information, and meeting regulatory requirements. This information will never be used for purposes outside of the obvious without your permission.

Consent*

We, the parent and/or legal guardian, declare that we have read and understand The Cridge Child Care Centre’s Admission Policies and Procedures. This includes the policy which states, “After a space has been accepted by the parent / guardian and the child is subsequently withdrawn prior to starting in the Centre, a 15% administration fee will be withheld from the original deposit (the balance will be refunded).”

Consent*
We, the parent and/or legal guardian, declare that we have read and understand The Cridge Child Care Centre’s Guidance and Discipline Statement.

Name of Your Child*
First Middle Last

Date of Birth*
MM slash DD slash YYYY

Child's Gender*

Nickname

Address*
Street Address Address Line 2 City Province Postal Code

BC CareCard*

You can obtain the record at your local public health unit

Please upload your child's immunization record below*
Max. file size: 16 MB.
Contact your public health unit for the official immunization record.

Family Doctor/Pediatrician/Walk-in Clinic Name and Address*

Family Doctor/Pediatrician/Walk-in Clinic Phone Number*

Does your child have any allergies?*

Yes

No

What are those allergies?*

Is there any other information about your child that would be helpful for the staff to know?

According to the Car seat and Booster seat Legislation in BC , Children must ride in rear and forward-facing car seat until they are a minimum of 18 kg (40 pounds).

Children must ride in a booster seat until they are a minimum of 145 cm (4 feet, 9 inches) tall, or a minimum of 9 years old.
To comply with this legislation we are required to collect the following information about your child:

Child's weight (kg)*

Child's height (cm)*

About Your Family

Parent/Guardian #1*
First Last

Home Phone

Cellphone*

Email*

Work Phone

Work Hours*

Place of Work/School

Occupation:

Parent/Guardian #2*
First Last

Home Phone

Cellphone

Email

Work Phone

Work Hours

Place of Work/School

Occupation:

Names of Siblings (and their age)

Other adults at home

Pets

Custody restrictions*

Yes

No

Please upload a copy of the court order or restrictions below*
Max. file size: 16 MB.

Persons not permitted access to your child:

Emergency Contacts

The Centre’s staff will not release your child to an unauthorized person unless you provide us with written permission prior to the event. Therefore, please provide the Centre with at least two emergency contacts in addition to yours, persons who are authorized to drop off and pick up your child.

Name*
First Last

Relationship

Primary Phone Number*

Secondary Phone Number

Name*
First Last

Relationship

Primary Phone Number*

Secondary Phone Number

Name
First Last

Relationship

Primary Phone Number

Secondary Phone Number

Permission Form

On occasion The Cridge Child Care Centre receives a request from other professionals or the community to observe the program; we attempt to do this with the least disturbance to the children’s routine. I hereby give permission for my child to be present on these occasions.*

Yes

No

In the event that your child needs medical attention, The Cridge staff will attempt to contact you or your emergency contact persons. If the staff cannot reach anyone, and your child has to be taken to an emergency clinic, the staff will do so by ambulance, The Cridge vehicle or taxi at The Cridge Centre’s expense. We will continue to attempt to reach you and your emergency contact persons. I hereby give permission for The Cridge staff to take my child to an emergency clinic.*

Yes

No

Photo Permission Form

I hereby give permission to have pictures and/or videos taken of my child, in the program setting for the following:*
Internal use (for example, posters in classroom, year-end slide show)
Digital Media (Facebook, Twitter, Instagram official pages, digital ads)
Print Media (for example, brochures, The Messenger, newspaper ads)
Other

If other, please specify*

Consent
I would like to receive communications from The Cridge Centre by email. I understand that I can unsubscribe at any time or change my preferences. I will receive information about the program I am registered in, occasional newsletters, updates and opportunities to participate.

Client Code of Conduct

I understand as a participant in The Cridge Centre for the Family that I am responsible for my behaviour.

I will act in ways that bring respect to me, my family and friends, and other participants within the program.

I will not use bad language, swear, insult, or fight with other people. I will refrain from any form of personal abuse towards others, including verbal, physical, and emotional abuse.

I will participate actively in the program.

I will let the organization know if my plans change and I am unable to keep an appointment or participate in an activity.

I will ask any participants if I may call them at home. If they agree, I will be reasonable and responsible about the time of day and how often I call.

I will keep in contact with the organization’s staff by responding to phone calls, letters, and other means of communicating promptly.

If a problem develops, I will immediately talk to my family or caregiver and/or a representative from the organization about it.

If a problem develops within my family or other circumstances occur that affect my participation in the program, I will contact the organization.

I agree to follow all established rules and guidelines of the organization.

Consent*
I read and agree with the Client Code of Conduct.

Consent*
I understand that The Cridge Centre Child Care programs will provide a one-month provisionary period prior to final enrollment. During this time the child is observed and assessed to ensure that they are able to adjust to the new environment and make new friends. For the well-being of the child in the event your child is not adjusting well to the new environment, The Cridge Centre for the Family retains the right to discontinue the enrollment. Parents also have the right to discontinue enrollment in the program during this trial period with full refund of your deposit in either case.

Name*
First Last

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Daycare Registration Form - EXTENDED

About Your Family

Emergency Contacts

Permission Form

Photo Permission Form

Client Code of Conduct

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