today's date *
today's date
parent's information *
parent's information
child's information *
child's information
child's birthdate *
child's birthdate
phone *
phone
address *
address
emergency contact *
emergency contact
emergency contact's phone number *
emergency contact's phone number
• Booking must be made before class starts - Maximum time allowed per day: 2 hours • For the well being of the other children, please refrain from bringing a sick child into the childcare area. They will not be accepted into care. • Please label all of your child’s belongings with his/her name. • Please bring an appropriate snack and water for your child. This is a NUT FREE environment. All allergies must be identified on registration form. • The child room will provide age appropriate toys. For safety and hygiene reasons we ask that children refrain from bringing their own toys to the child care area, unless otherwise agreed by management. • Children will remove shoes while in the childcare room. Please feel free to bring a pair of socks for comfort. • In the case of consistent disruptive or inappropriate behaviour to other children, parents will be called to return to child care area and asked to assist. • If a child is inconsolable for more than 15 minutes, parents will be notified and asked to return to the childcare area to assist staff. • Children will be released ONLY to the person who dropped them off. • Medications will not be administered by childcare staff. • Please bring your child freshly diapered. • All dirty diapers must leave with the child. They cannot remain on site.
I, the undersigned, hereby hold harmless, waive and release SHAMANA CIRCLE, their childcare workers, officers, representatives, agents, organisers and successors from liability as a result of personal injury or property damage occurring while the above child/children is/are in their care at SHAMANA CIRCLE. I understand that this is not a licensed childcare facility. I understand that childcare services are provided only while I am present in the building and training. I understand that childcare services are provided for a nominal fee. I understand that if my child should become inconsolable during the class session, I am responsible to leave class and attend my child. I have read, understand and agree to adhere to the Child Care Policies of SHAMANA CIRCLE listed above.
acknowledgment *