Please select which session you are applying for:

Toddler program (18 months to 2 1/2years old):    

Preschool program (2 1/2 - 5 1/2 years old):

Preferred Date of Enrolment

CHILD

Name

Child's Address

Birth Date (DD/MM/YYYY)

Language spoken at home:

Has your child had any previous school experience?   Yes No

If yes, where ? Duration:

MOTHER

Name:

Home Address:

Postal Code:

Home Phones:      Cellular Phone:

Occupation:      Business Phone:

Business Address:

Email Address:

FATHER

Name:

Home Address:

Postal Code:

Home Phone:      Cellular Phone:

Occupation:      Business Phone:

Business Address:

Email Address:

HEALTH INFORMATION

Pediatrician's Name:

Address:

Phone:

Allergies:

Restrictions:

What communicable disease has your child been exposed to:

Other useful information:

Please provide name(s) address, Tel. No. of person(s) who may collect your child at a short notice:

IN CASE OF EMERGENCY, PLEASE CONTACT:

Name:     Phone Number:

Relationship:      Address:

Name:     Phone Number:

Relationship:      Address:

Name:     Phone Number:

Relationship:      Address:

I am also interested in the following:

Extended care (7:30am – 8:00am)

Before School Program (8:00am - 8:45am)

After School Program (3:45pm - 5:30pm)

Extended care (5:30pm – 6:00pm)

Where did you hear about Leaside Children's House?

In order for your child's application to be processed for enrollment it is necessary to include the following items:

1. A copy of your child's birth certificate (record of landing/passport)

2. A copy of your child's latest and any other educational assessment reports

3. A non-refundable deposit equivalent to your monthly tuition (This will pay the June tuition ONLY)

4. A non-refundable enrolment fee of $150 payable to Leaside Children's House (Once a spot has been offered).

5. Post-dated cheques for the rest of the school year

6. A signed emergency medical treatment authorization form

7. A copy of your child's immunization record

Note: Sixty days written notice is required in the event of an early withdrawal from the school and at this time, the school will return any post-dated cheques on file.

Please call in advance for space availability. Please note that a $20 non refundable application fee is required.

Please submit this application form and mail or drop off all necessary items in an envelope. Thank you for selecting Leaside Children's House

Leaside Children's House has a non-discriminatory policy relative to race, religion, and national origin with respect to admission of students and the employment of faculty and administrative staff. Leaside Children's House considers the records of all individual students to be confidential information available to a child's parents or guardians upon request. Records will only be released to other schools or agencies upon a signed request from the parent or guardian and only after all accounts due are paid in full.