Enrollment Form | King City Montessori School

Program

Child Info

Parent Info

Medical Info

Emergency

Documents

Review

Step 1: Program Selection

Select Program *

Desired Start Date *

Schedule Preference *

Full-time (5 days/week)Part-time (3 days/week)

Additional Notes (Optional)

Step 2: Child Information

Child's First Name *

Child's Middle Name

Child's Last Name *

Date of Birth *

Gender

Allergies

Medical Conditions

Special Needs or Accommodations

Previous Daycare/School Experience

YesNo

Step 3: Parent/Guardian Information

Primary Parent/Guardian

First Name *

Last Name *

Relationship to Child *

Email Address *

Phone Number *

Alternate Phone Number

Mailing Address *

City *

Province *

Postal Code *

Occupation

Employer

Add Second Parent/Guardian

Secondary Parent/Guardian

First Name

Last Name

Relationship to Child

Email Address

Phone Number

Step 4: Medical Information *

This section is mandatory. Please complete all required fields as per Ontario Ministry of Education requirements for daycare enrollment.

Health Card Information

Ontario Health Card Number *

Format: 1234-567-890-AB

Health Card Version Code

Primary Healthcare Provider

Doctor/Healthcare Provider Name *

Doctor/Healthcare Provider Phone *

Doctor/Healthcare Provider Address

City

Province

Allergies & Dietary Restrictions

Does your child have any known allergies? *

YesNo

Please list all allergies: *

Severity of Allergic Reactions

Treatment Required (if applicable)

Does your child require an EpiPen or other emergency medication? *

YesNo

Medical Conditions

Does your child have any ongoing medical conditions? *

YesNo

Please describe all medical conditions: *

Current Treatment/Medications

Activity Restrictions (if any)

Medications

Does your child require medication during daycare hours? *

YesNo

Medication Details *

Medication Administration Authorization *

I authorize the daycare staff to administer the above medications according to the instructions provided. I understand that medication must be provided in its original container with pharmacy label.

I authorize medication administration as described above *

Immunization Status

Is your child's immunization up to date? *

Yes, up to datePartially immunizedNot immunizedMedical/Religious exemption

Immunization Notes

Special Health Needs & Accommodations

Special Health Needs or Accommodations

Dietary Restrictions or Special Dietary Requirements

Emergency Medical Procedures Authorization

In case of a medical emergency, I authorize: *

The daycare to seek emergency medical care for my child, including calling 911 and transporting my child to the nearest hospital if necessary *Medical personnel to provide emergency treatment as deemed necessary *I understand that I will be contacted as soon as possible in any emergency situation *

Additional Emergency Medical Instructions

Medical History

Previous Hospitalizations or Surgeries

Relevant Family Medical History

Parent/Guardian Declaration

I declare that the information provided in this medical information form is accurate and complete to the best of my knowledge. I understand that it is my responsibility to inform the daycare immediately of any changes to my child's medical condition, medications, or health status.

Parent/Guardian Name *

Date *

I declare that the information provided is accurate and complete *

Step 4: Emergency Contacts

Please provide at least two emergency contacts (other than parents/guardians).

Emergency Contact 1 *

Full Name *

Relationship *

Primary Phone *

Alternate Phone

Email Address

Emergency Contact 2 *

Full Name *

Relationship *

Primary Phone *

Alternate Phone

Email Address

Step 5: Documents & Additional Information

Required Documents

Please upload the following documents. Accepted formats: PDF, JPG, PNG. Maximum file size: 5MB per file.

Birth Certificate *

Upload a copy of your child's birth certificate

Immunization Records *

Upload your child's up-to-date immunization records

Health Information Form

Download and complete our health form, then upload (optional at this stage)

Child's Photo (Optional)

A recent photo of your child (for our records)

Additional Information

How did you hear about us?

Special Requests or Additional Notes

Step 6: Review & Submit

Please review all information before submitting. You can go back to edit any section.

Terms & Conditions

I have read and agree to the Terms of Service*

I have read and agree to the Privacy Policy*

Payment Required

A non-refundable registration fee of $200.00 is required to complete your enrollment application.

Pay Registration Feeor pay after submission