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Parent Information

Avalon Montessori School

Student Registration Package – Elementary

Step 1 of 10

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Student Information
Child’s Given Name
First Middle Last
Child goes by
Gender
- Male
- Female
Gender child identifies with and pronouns
Age
Date of Birth
Date Format: MM slash DD slash YYYY
Complete Address
Street Address City State / Province / Region ZIP / Postal Code
Child’s citizenship:
Languages spoken at home

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Guardian Information
Guardian #1 Information
Guardian #1: Name
Guardian #1: Name
First Last
Home Address
Same as child's

Street Address City State / Province / Region ZIP / Postal Code
Home Phone
Cell Phone
Business Phone
Email Address
Business Address
Occupation
Parent #2 Information
Guardian #2 Name
First Last
Home Address
same as above

Street Address City State / Province / Region ZIP / Postal Code
Home Phone
Cell Phone
Business Phone
Email Address
Business Address
Occupation

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Student Emergency Information (other than parents)

Emergency Contact Name #1
Telephone Number
Relationship to Child
Emergency Contact Name #2
Telephone Number
Relationship to Child

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Student Medical Information
Doctor’s Name
Doctor’s Address
Street Address City State / Province / Region ZIP / Postal Code

Doctor’s Phone Number
Under the Personal Health Information Protection Act, 2004, we are no longer required to obtain your child’s Ontario Health Card Number. Therefore, providing this information is optional.
Ontario Health Card Number
Allergies/Sensitivities/Diet Restrictions:
A copy of the student’s CURRENT Immunization Record is compulsory - official confirmation of immunization for DPT&P(Diphtheria, Pertussis, Tetanus and Polio), MMR (Measles, Mumps and Rubella) HIB and/or any other pertinent information.
Upload a copy of the student’s CURRENT Immunization Record

Drop files here or

Has the child had a tuberculin test?
Yes
No
If yes, please provide date of test and advise if test was positive or negative.
Has your child had any communicable diseases such as chicken pox, mumps, etc?
Yes
No
If yes, please specify type and advise dates:
Does child take any medication regularly?
Yes
No
If yes, please advise name of drug(s):
Reason for drug and dosage details:
Please include written instructions for any medical treatment, drug or medication to be administered during the hours your child is in attendance. It is advised you also speak with your child’s teacher(s) prior to the start of school.
Please specify any social, emotional or medical problems that the School should be aware of:
Please specify any special requirements in respect of rest or exercise:
Dietary Restrictions?
Yes
No
Dietary Restriction
Medical
Religious
Registered in Learning Support Program?
Yes
No
Reason for Placement in Learning Support Program
Please indicate the dates of any relevant psychological or educational assessments and include administering agency. Copies of assessments must be submitted as part of the Student Information Package.
Upload copies of assessments

Drop files here or

Previous School(s) attended. Please include full name and dates attended.
Name(s) and age(s) of siblings:
Those attending Avalon:
How did you learn about Avalon Children’s Montessori School?
Please indicate relevant custodial issues

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Additional Information
Name of persons to whom your child may be released to, including relationship:
Name Relationship Telephone

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Medical Waiver
Please check the box beside the statement.
I understand that in the event of an accident or illness occurring to my child, the School will make every attempt to contact me and/or my spouse. If however, I or my spouse cannot be reached, I hereby give Avalon Children’s Montessori School, its Directors, Officers, Agents and Employees authority to act on my behalf in case of emergency and to take appropriate steps to have a doctor attend to my child.
Please check the box beside the statement.
I also agree to release and indemnify Avalon Children’s Montessori School, its Directors, Officers, Agents and Employees from any and all claims for damages arising from any injury or otherwise related actions to my child as a result of any accident, illness, injury or for any other reason arising from participation in any school activities.
Permission to go on Outings
Please check the box beside the statement.
My son/daughter has permission to take part in any out-of-school events during the school year. I will be notified again in writing before any particular visit or trip.
School Policies
Please check the box beside the statement.
I have received, read and understand the School Policies for Avalon Children’s Montessori School.
Code of Conduct
Please check the box beside the statement.
I have received, read and understand the Code of Conduct for Avalon Children’s Montessori School.
Photographic Waiver
Please check the box beside the statement.
I authorize my child’s photograph to be used for school activities and school purpose only.
CASL
In accordance with Canada’s new anti-spam legislation, please indicate if we may contact you via email regarding updates and information about Avalon.
Yes
No
Please check the box beside the statement.
I/We hereby declare that all the above information provided is current and up to date. I/We will notify the School immediately should any information change.

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Dear Parent(s)/Guardian: In accordance with the guidelines for the Ontario Student Record and in the Freedom of Information Act, Avalon Children’s Montessori School requires consent from the parent or guardian to request student records from the previous school attended. Please complete the Consent for Transfer of School Records in BOX 1
BOX 1
Name of Student
Please check the box beside the statement.
I hereby consent to the transfer of student records for my child to Avalon.
Date of Birth
Date Format: MM slash DD slash YYYY

Entering Grade
Name of School presently attending
Address of school presently attending
Street Address City State / Province / Region ZIP / Postal Code

Email address of school presently attending

With the email provided, we will send an email to the school to upload the student records.
Parent/Guardian Signature
Date
Date Format: MM slash DD slash YYYY

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Terms of Contract

1. A student is considered fully registered upon submission of a completed Enrolment Package, including a non-refundable deposit and a completed Tuition Schedule.

2. A returning student is considered accepted into the School only upon confirmation by the School. The decision to invite a student back for another academic year is made at the sole discretion of the School. Students invited to return to Avalon will receive a Re-enrolment Form prior to the end of their school term.

3. With all methods of payment, a deposit is due at the time of registration or re-enrolment. This fee is non-refundable.

4. All post-dated cheques, for tuition and extended care, must be dated the first of each payable month. The child’s full name must be written on the front of each cheque.

5. E-Transfer payments are due on the first of each month and no later.

6. Tuition payments made by credit card are not eligible for discounts and are processed at the start of each month.

7. Failure to keep tuition payments current will result in suspension from the School. Students may not return until tuition account is current.

8. The person(s) responsible for tuition must complete the accompanying form.

9. Written notice of a student’s withdrawal must be received prior to December 15. After this date, parents may be responsible for the remaining school year’s fees.

10. There are no refunds for mid-month withdrawals, holidays, sick days or days missed for any other reason throughout the school year.

11. A charge of $25 may be levied against payments not made on time or returned for insufficient funds.

12. There is a late pick-up charge which is applied at the rate of $15.00 for the first 15 minutes and $1.00 per minute for every additional minute, whenever a staff member must stay beyond established hours to care for a child due to a tardy parent/caregiver. The same rate is applied to early arrivals.

13. Transportation to and from the School is the responsibility of the parent/guardian.

14. Extended Care costs, transportation costs, uniforms and field trip charges are not included in the tuition costs for the academic year in which your child is enrolled.

15. Avalon Children’s Montessori School reserves the right to suspend or expel any student failing to adhere to the Discipline Policy of this School.

16. Avalon Children’s Montessori School reserves the right to suspend or expel from the school anyone who does not adhere to the Code of Conduct.

17. Students do not automatically progress from the Casa Programme to the Elementary Programme. Avalon Children’s Montessori School reserves the right to invite applicants in their final Casa year to the Elementary School.

1. A student is considered fully registered upon submission of a completed Enrolment Package, including a non-refundable deposit and a completed Tuition Schedule. 2. A returning student is considered accepted into the School only upon confirmation by the School. The decision to invite a student back for another academic year is made at the sole discretion of the School. Students invited to return to Avalon will receive a Re-enrolment Form prior to the end of their school term. 3. With all methods of payment, a deposit is due at the time of registration or re-enrolment. This fee is non-refundable. 4. All post-dated cheques, for tuition and extended care, must be dated the first of each payable month. The child’s full name must be written on the front of each cheque. 5. E-Transfer payments are due on the first of each month and no later. 6. Tuition payments made by credit card are not eligible for discounts and are processed at the start of each month. 7. Failure to keep tuition payments current will result in suspension from the School. Students may not return until tuition account is current. 8. The person(s) responsible for tuition must complete the accompanying form. 9. Written notice of a student’s withdrawal must be received prior to December 15. After this date, parents may be responsible for the remaining school year’s fees. 10. There are no refunds for mid-month withdrawals, holidays, sick days or days missed for any other reason throughout the school year. 11. A charge of $25 may be levied against payments not made on time or returned for insufficient funds. 12. There is a late pick-up charge which is applied at the rate of $15.00 for the first 15 minutes and $1.00 per minute for every additional minute, whenever a staff member must stay beyond established hours to care for a child due to a tardy parent/caregiver. The same rate is applied to early arrivals. 13. Transportation to and from the School is the responsibility of the parent/guardian. 14. Extended Care costs, transportation costs, uniforms and field trip charges are not included in the tuition costs for the academic year in which your child is enrolled. 15. Avalon Children’s Montessori School reserves the right to suspend or expel any student failing to adhere to the Discipline Policy of this School. 16. Avalon Children’s Montessori School reserves the right to suspend or expel from the school anyone who does not adhere to the Code of Conduct. 17. Students do not automatically progress from the Casa Programme to the Elementary Programme. Avalon Children’s Montessori School reserves the right to invite applicants in their final Casa year to the Elementary School.
Please check the box beside the statement.
We have read and understand the Terms of Contract.

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Avalon Children’s Montessori School Tuition Payment Agreement
I/We are responsible for the tuition payments for the following student:
Please check the box beside the statement.
I/We have read the tuition and payment refund policy for Avalon Children’s Montessori School and agree to adhere to it. I/We understand that failure to keep the account current will result in suspension from school of the above mentioned child until the outstanding fees are paid.
Name
First Last
Address
Same as Child's

Street Address City State / Province / Region ZIP / Postal Code

Relationship to student
Signature
Date
Date Format: MM slash DD slash YYYY

Name
First Last
Address
Same as Child's

Street Address City State / Province / Region ZIP / Postal Code

Relationship to student
Signature
Date
Date Format: MM slash DD slash YYYY

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Student Media Consent and Release
Name of Student
By my signature at the bottom of this Student Media Consent and Release, I hereby agree to the following in respect of the student (the “Participant”):

I consent to the collection of, and grant full permission in perpetuity to Avalon Children’s Montessori School to copy, reproduce, use, reuse, license, exhibit, display, distribute and create derivative works of any photographs, slides, films, videotapes, recordings or any other content taken of the Participant in connection with Avalon Children’s Montessori School (the “Materials”), whether in print, CD-ROM, videotape, electronic or other format for any purpose whatsoever (including, but not limited to, promotional materials such as informational brochures, websites, television shows and public information campaigns) and with no financial or other consideration to be paid to the Participant in connection therewith. The Participant or, if the Participant is under the age of 18, the parent/legal guardian of the Participant, acknowledge and accept that Materials may be edited at the sole discretion of Avalon Children’s Montessori School. I understand that Avalon Children’s Montessori School is not obligated to use the Materials and that they will not be provided or returned to the Participant.

I agree to indemnify Avalon Children’s Montessori School, its officers and directors, in respect of any claims made by third parties against Avalon Children’s Montessori School or any person included in events that the rights granted herein violate any other obligation of the Participant.

I agree that if the Participant suffers any loss, claims, damages or injuries arising out of any use of the Materials, I will not make a claim against Avalon Children’s Montessori School or its employees, officers or directors and I hereby release them from any such claims.

Since the Participant is under the age of 18, I represent that I am the parent or legal guardian of the Participant, that I am authorized to sign on behalf of the Participant, that I agree to the terms of this Student Media Consent and Release and that I shall be bound thereby.

I consent to the collection of, and grant full permission in perpetuity to Avalon Children’s Montessori School to copy, reproduce, use, reuse, license, exhibit, display, distribute and create derivative works of any photographs, slides, films, videotapes, recordings or any other content taken of the Participant in connection with Avalon Children’s Montessori School (the “Materials”), whether in print, CD-ROM, videotape, electronic or other format for any purpose whatsoever (including, but not limited to, promotional materials such as informational brochures, websites, television shows and public information campaigns) and with no financial or other consideration to be paid to the Participant in connection therewith. The Participant or, if the Participant is under the age of 18, the parent/legal guardian of the Participant, acknowledge and accept that Materials may be edited at the sole discretion of Avalon Children’s Montessori School. I understand that Avalon Children’s Montessori School is not obligated to use the Materials and that they will not be provided or returned to the Participant. I agree to indemnify Avalon Children’s Montessori School, its officers and directors, in respect of any claims made by third parties against Avalon Children’s Montessori School or any person included in events that the rights granted herein violate any other obligation of the Participant. I agree that if the Participant suffers any loss, claims, damages or injuries arising out of any use of the Materials, I will not make a claim against Avalon Children’s Montessori School or its employees, officers or directors and I hereby release them from any such claims. Since the Participant is under the age of 18, I represent that I am the parent or legal guardian of the Participant, that I am authorized to sign on behalf of the Participant, that I agree to the terms of this Student Media Consent and Release and that I shall be bound thereby.
Please check the box beside the appropriate statement:
I do consent to the above while my child(ren) is/are enrolled at Avalon Children’s Montessori School.
I do not consent to the above while my child(ren) is/are enrolled at Avalon Children’s Montessori School.
Name of Parent/Guardian
Parent/Guardian Signature
Date
Date Format: MM slash DD slash YYYY

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