Emergency Contact Persons (only if parent(s) not available):

    Child may be released to:

    Parent's Signature

    Supervisor's Signature

    Permission to Receive Emergency Medical Care

    I, hereby grant permission for the operator, or designate, of this child care centre to take whatever steps are necessary when accidents, sudden illnesses, or other emergencies occur. Necessary steps will be taken to obtain emergency medical care for my child if warranted

    The steps may include, but are not limited to, the following:
    1. Attempt to contact a parent or guardian.
    2. Attempt to contact child’s physician.
    3. Attempt to contact emergency contact person.
    If we cannot contact parent/guardian, your child’s physician or an emergency contact person will do any or all of the following:
    1. Call another physician.
    2. Call an ambulance.
    3. Have the child taken to the emergency department, in the company of a staff member.
    Any expenses incurred under circumstances listed above will be borne by the child’s family.
    THE CHILD CARE CENTRE WILL NOT BE RESPONSIBLE FOR ANY INCIDENT THAT MAY OCCUR AS A RESULT OF FALSE INFORMATION GIVEN AT THE TIME OF ENROLMENT.

    Parent's Signature*

    Date*

    Witness's Signature

    Date

    Emergency Record

    Emergency Contact Persons (only if parent(s) not available):

    Child’s Health History

    Parent’s Signature for Immediate Medical Attention*

    Child’s Health History Form

    Immunization Information

    My Child Has:


    Parent's Signature*

    Date*

    Consent Form for Outings

    I, ,hereby consent to have leave the premises from time to time to participate in excursions to places of interest, planned as part of the children’s program.
    It is understood that supervision will be provided by members of the staff.

    NOTE: Advanced notice will be given on planned field trips.

    Parent's Signature*

    Date*

    Consent Form for Video & Photographs

    I, ,hereby give permission to Zoe’s Tender Years Child Care to use photographs of in any daycare related newsletters, bulletin boards and internet viewing (that is password protected at all times).

    NOTE: Individual identities of all children will be kept strictly confidential.

    Parent's Signature*

    Date*

    Child’s Profile

    I, have brothers.

    I, have sisters.

    If YES, please input previous Daycare Provider’s information:


    Childcare Contract

    This contract is made between:
    And
    And
    Zoe’s Tender Years Child Care Centre
    8551 Weston Road
    Woodbridge, Ontario
    L4L 9R4

    I agree to pay $ per for the care for my child, due on the 1st of each month. This fee will be charged for all contracted months regardless of holidays, sick days or other absences. (Please note: Prices are subject to change)
    I agree to abide by the overtime policies and fees as set forth in the parent handbook.

    TERMINATION: In case of termination of care, both parties agree to submit to the other a one month written notice stating date of termination. I understand that I will be charged my normal child care fees during this period. Advanced payment is required for the entire one month period and is due upon submission of written termination.

    I have received, read, understood and agreed with the policies and procedures in Zoe’s Tenders Years Child Care Centre’s handbook.

    Mother/Legal Guardian’s Signature*

    Date*

    Father/Legal Guardian’s Signature*

    Date*

    Supervisor's Signature

    Date

    Deposit/Registration Fee for Child Care Services

    To:

    Zoe’s Tender Years Child Care Centre
    8551 Weston Road
    Woodbridge, Ontario
    L4L 9R4

    From:
    Re: Child Care Deposit of $250.00 per child & One-Time Registration Fee of $100.00 (Non-Refundable)

    I, ,have agreed to Childcare services provided by Zoe’s Tender Years Child Care Centre for my child . I have made a deposit of $250.00 for the Childcare services, as well as a one-time registration fee of $100.00. I acknowledge that if I, make any changes to the agreement above, the childcare center will not be obligated to make this fee refundable.

    Parent’s/Legal Guardian’s Signature*

    Date*

    Supervisor’s Signature

    Date