Montessori School
TODDLER BUNNIES
CASA SQUIRELS
KINDER CASA FOXES
ELEMENTARY OWLS
Forest School
Spanish Si!
Admissions
Faculty
Contact
Gallery
Montessori School
TODDLER BUNNIES
CASA SQUIRELS
KINDER CASA FOXES
ELEMENTARY OWLS
Forest School
Spanish Si!
Admissions
Faculty
Contact
Gallery
Printable Download
Toddler Bunnies
Toddler Bunnies
For Office use only / Date of Admission:
Date of Discharge:
Location:
Guarantee:
Instruction:
Type of Child Care Required - Age Group Placement at Time of Enrolment
*
Full-time
Toddler 2025-2026 (18 months - 3 years)
Toddler Summer Program (July and August)
Before Care
After Care
Lunch from home due to dietary reasons
PRE-REGISTRATION IS REQUIRED FOR BEFORE AND AFTER SCHOOL PROGRAM
Child Information
*
First Name
*
Last Name
Date of Birth
*
Gender
*
Male
Female
Age (Years, Months)
*
Language (S) Spoken at Home:
*
Other children in the family enrolled
*
Other children in the family enrolled in the centre (list names, if applicable):
Parent Information 1
*
Full Legal Name
Relationship to Child
*
Primary Phone Number
*
Alternative Phone Number
*
Home Address
*
Same as Child
Email Address
*
Occupation
*
Parent Information 2
*
Full Legal Name
Relationship to Child
*
Primary Phone Number
*
Alternative Phone Number
*
Home Address
*
Same as Child
Email Address
*
Occupation
*
Custody Arrangements (if applicable)
Are there custody arrangements pertaining to legal right of access to your child? If YES, please provide a copy of the appropriate legal documentation (e.g court order).
Custody Arrangements (if applicable)
*
YES
NO
Permitted to access/pick up your child
*
Name(s) of custodial parent(s) permitted to access/pick up your child
PROHIBITED from accessing/picking up your child
Name(s) of individuals prohibited from accessing/picking up your child
Pick-Up Authorization
The following additional individuals are authorized to pick up my child (Photo ID will be required to con rm identify before the child will be released): If YES, please provide a copy of the appropriate legal documentation (e.g court order).
Full Legal Name
*
Relationship to Child
*
Primary Phone
*
Full Legal Name
*
Relationship to Child
*
Primary Phone
*
Full Legal Name
Relationship to Child
Primary Phone
Additional Emergency Information
*
Please provide any special medical or additional information about your child that could be helpful in an emergency (e.g., known medical conditions, skin conditions, vision/hearing difficulties)
Health Information
*
If your child has had any history of communicable diseases (e.g., chicken pox, measles), please list them
Health Card Number
*
Doctor Name
*
Doctor's Phone
*
Medical Needs
Does your child have any medical need(s) that requires additional support (e.g., Diabetes)?
Medical Needs
*
YES
NO
If yes,
an individualized plan for children with medical needs must be developed between the parent and the child care centre prior to the child’s first day of care.
Statement of Conscious/Immunization Records
Please provide a copy of your child’s immunization record (e.g., yellow card) to the centre prior to your child’s rst day of care. If you do not have an immunization record.
Immunization
If you have chosen not to immunize your child, a Statement of Medical Exemption form or a Statement of Conscious or Religious Belief form must be completed and provided to the centre. These forms are available on the Ministry of Education’s website. Allergy
Allergy Information
Does your child have a life-threatening allergy (e.g., anaphylactic to peanuts or bee stings)?
Allergy Information
*
YES
NO
If yes,
an individualized plan for an anaphylactic allergy that includes emergency procedures must be developed between the parent and the child care centre prior to the child’s start date.
Other Allergies
Does your child have any allergies that are not life-threatening (food or other substance [e.g., latex])?
Other Allergies
*
YES
NO
If yes,
please provide relevant details, including what your child is allergic to, symptoms of a reaction and treatment required
Dietary and Feeding Arrangements
Dietary requestes such as vegetarian, meetless,etc
Dietary and Feeding Arrangements
*
YES
NO
If yes,
please provide relevant details:
Dietary Requirements
Does your child have any special dietary requirements or restrictions (e.g., vegetarian, kosher, halal)?
Dietary Requirements
*
YES
NO
If yes,
please provide relevant details:
Physical Requirements
Does your child have any special sleep requirements (e.g., specific comfort item, soother)?
Physical Requirements
*
YES
NO
If yes,
please provide relevant details:
Sleep Information
*
How many naps does your child typically have each day?
Sleep time
*
At what times does your child typically nap?
Nap time
*
At what times does your child typically nap?
Long Nap
*
How long does your child usually nap?
Special Sleep Requirements
Does your child have any special sleep requirements (e.g., specific comfort item, soother)?
Special Sleep Requirements
*
YES
NO
If yes,
please provide relevant details:
Special Requirements
Does your child use diapers?
Special Requirements
*
YES
NO
If no, my child:
*
Uses the washroom independently
Requires some assistance
Requires full support
Relevant details
*
Please provide relevant details:
Accommodation
Does your child require any additional support or accommodation with respect to physical activity?
Accommodation
*
YES
NO
If yes,
please provide relevant details:
Photograph and Video Consent
*
YES
NO
I give permission to Terra Viva Montessori staff to take photographs of my child. It is understood that the pictures may be used in promoting school programs such as in years or website and on social media. It is also understood by both parents and TVM that children’s names will not appear in the promotional material. Permission for Facebook, Instagram, and Social Media.
Parent/Guardian
*
Parent/Guardian
First Name
First Name
Last Name
Last Name
Date
*
Parent/Guardian
Parent/Guardian
First Name
First Name
Last Name
Last Name
Date
Parent Handbook, General Policies and procedure Authorization and Agreement
By signing below, I indicate that I have received a copy, read and will abide by the written policies and procedures at Terra Viva Montessori. I understand that TVM may change these written polices from time to time. A revised Parent Handbook of the policies and procedures will be provided to parents /guardians at least 1 week before changes/additions become effective.
Parent/Guardian
*
Parent/Guardian
First Name
First Name
Last Name
Last Name
Date
*
Terra Viva Forest School Waiver
I grant permission for (Printed full name of participant:) to participate in Terra Viva’s Forest Program.
Parent/Guardian
*
Parent/Guardian
First Name
First Name
Last Name
Last Name
I understand
that participation in activities can expose the named participant to risk and possible injuries, which include bumps, bruises, cuts, strains, sprains, concussions, broken bones, stings, bites, and other possible trauma.
I understand
that there is a qualified certified First Aider on site and grant permission for them to treat the above named participant in the event of an injury.
I understand
that by initialing and signing this document I hereby release TERRA Forest School from any and all liability associated with the program my child is attending
I recognize
that TERRA VIVA Forest School program reserves the right to postpone or cancel programs/sessions due to unsafe weather conditions or other unforeseen circumstances. Where possible TERRA Forest School program will attempt to reschedule, but this may not be possible. I will not hold TERRA Forest School program liable for loss of fees or programs due to weather or other unforeseen circumstances that will jeopardize the health and safety of staff and participants.
All tools
and materials will be provided by TERRA VIVA Forest School program. Participants are discouraged from bringing additional items to sessions as they may be lost, stolen, or damaged.
I will not
hold TERRA Forest School program responsible for any lost, stolen or damaged personal items. I have provided TERRA Forest School program with all significant medical information and will ensure that the participant’s important medications are provided, location identified, and with the participant during all TERRA Forest School program sessions.
I understand
that it is my responsibility to ensure that the named participant is dressed properly for weather conditions as this is a program largely based outside in natural settings. I understand that the participant may be refused admission to a session if they are not clothed properly for the conditions and I will not hold Wild TERRA VIVA Forest School program responsible.
While participating
in the TERRA VIVA Forest School program, I understand that the named participant will be required to listen and follow the guidance of TERRA Forest School Leaders. This includes participation in outlined activities, expectations for age appropriate behaviour, and being able to respect the health, safety for themselves and any member of the group. If for any reason the named participant is unable or unwilling to follow expectations, engage in acceptable behaviour, or acts in an unsafe manner towards themselves or others, they may be removed from the session or the entire program.
I understand
that TERRA Forest School reserves the right to deny access to a participant who has been disruptive in the past or sent home because of behaviour issues. In the event that: the participant’s behaviour is felt to be unsafe or unmanageable if an illness or injury should arise in which a doctor's diagnosis is required unsafe weather conditions develop other unsafe conditions develop that require participant’s removal from program I authorize TERRA Forest School to dismiss my child early, in which case I will assume responsibility for transporting my child from the program at a time specified.
I acknowledge
that I have read and fully understand this agreement, and accept the risks involved with the above named participant’s engagement in these activities at TERRA Forest School.
Parent/Guardian
*
Parent/Guardian
First Name
First Name
Last Name
Last Name
*
Relationship to the minor
Date
*
Head of School/Supervisor Name
Head of School/Supervisor Name
First Name
First Name
Last Name
Last Name
Date
Submit
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Montessori School
Forest School
Spanish Si!
A
dmissions
Faculty
Contact
Gallery
St Catharines On
325 Scott street
92 Main street
289-9901320