* = Required Information
PERSONAL INFORMATION: (All fields are required)
Male Female

Who may we release your child to?
Emergency Contacts (other than parents)
(if no address is provided, we will contact them to get it)
School Information (Only for children attending School)
Health Information
Yes No
Application Signature
Entering your name below is equivalent to signing a binding agreement on paper.

Accident / Sickness Policy
In the event of a medical emergency, I understand that every effort will be made to contact me or the emergency contact person(s). In the event that none of the above can be reached, I give permission to the staff of First Choice Daycare to seek any medical treatment necessary for the child named above. I agree to be responsible for any cost incurred.

Field Trip Policy
I authorize the staff of First Choice Daycare center to take my child off its premises for the purpose of outdoor activities. Please note: for any major outings, parents will be notified.

Transportation Policy
I give permission to the staff of First Choice Daycare centre to transport (by: city bus, walking, school bus, taxi) my child in the event of field trips and/or an emergency situation. I also give permission to the staff of First Choice Daycare to transport my child(ren), walking, to and from St. Pius School. (8:30 am and 3:00 pm all days except Thursdays 8:30 am and 12:00 pm) . I will inform the daycare of any changes to schedules and/or if my child is not to be pick ed up by the daycare. If a school child did not show up at the regular grouping spot for OSC, we will make the following contacts in the following sequence if child is not found, or no response: School, Parents, Emergency Contacts, Police

Picture Release
I give permission to First Choice Daycare centre to photograph my child in his/her daily activities and daily events and understand that they may be displayed in the centre. No pictures will be used for publication or telecasts without parental permission.
I acknowledge that I have been provided and will read the contents of the parents handbook and agree with the con tents of the provided information from First Choice Daycare centre.
Word of Mouth
Driving/Passing around
Emergency Contact Information
Please fill in Emergency Contact Information

Yes No

If Emergency Contact 1 address is not provided, we have to call the contact person directly to get the address.

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