Registration & Authorization Form

Please fill out and submit our registration and authorization form. Download Printable Version Here.

School Year

Program

Student's First Name

Student's Last Name

Birth Date

Age

Gender

OHIP#

Names/Ages of Siblings

Student's Address

City

Postal Code

Student's Telephone

Parent/Guardian (Specify Mr./Mrs./Miss/Ms.)

Contact Numbers: Home

Work

Cell

Email

Parent/Guardian (Specify Mr./Mrs./Miss/Ms.)

Contact Numbers: Home

Work

Cell

Email

Work Address

Student's Physician

Physician's Telephone

Emergency Contact Home:

Work

Cell

Releationship to Student

Please list 2 people other than the contacts listed above who are authorized to pick up your child/ward at time of dismissal.

Contact 1:

Relationship

Tel#

Contact 2:

Relationship

Tel#

I hereby authorize that the people listed above are able to pick up my child/ward at time of dismissal if I am unable to do so.

Signature of Parent/Guardian

Date

I hereby give permission for my child/ward to be photographed for use in school media with the understanding that my child’s name will not be used.

Signature of Parent/Guardian

Date

I acknowledge that I have read the Enquiring Minds Montessori Parent Handbook found online. I understand that it contains information pertaining to the School’s policies and procedures. I agree that it is my responsibility to thoroughly read, to become familiar with, and abide by the handbook’s contents.

Signature of Parent/Guardian

Date

I hereby register my child/ward with Enquiring Minds Montessori Casa.

Signature of Parent/Guardian

Date

Student Photo