Milestone Education Center Early Learning & Inclusive CarePlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Please tick the age group you are enrolling your child in: *Infant (3–12 months)Toddler (1–3 years)Inclusive Program (All ages)Kindergarten (3–6 years)Choose Weekly Plan *$55 Per Week (No Meals)$85 Per Week (Meals Included)Holiday Care Plan ($55 No Meals)Holiday Care Plan ($85 Meals Included)A registration fee of $100 is required upon enrolment. This is non-refundable.SECTION 1: CHILD’S DETAILS Full Name of Child *FirstMiddleLastDate of Birth *Gender *FemaleMaleHome Address *Address Line 1CityState / Province / RegionStarting Date *SECTION 2: PARENT/GUARDIAN DETAILS Primary Contact: Name of Parent/Guardian *FirstMiddleLastRelationship to Child *Phone *Email *Emergency Contact (other than parent): Name of Emergency Contact Person *FirstMiddleLastPhone *Relationship *SECTION 3: HEALTH & DEVELOPMENT Allergies: If 'Yes', list: *YesNoList Allergies *Medical conditions or medications: If 'Yes', list: *YesNoList medical condition or medication required *Is your child immunized? If 'Yes', attach recordYesNoAttach Record Drag & Drop Files, Choose Files to Upload Special needs, support required, or therapies involved: *SECTION 4: GROUP-SPECIFIC REQUIREMENTS INFANTS (3–12 MONTHS) Please Bring: 2–3 sets of spare clothes (labelled) Baby formula or breast milk (clearly labeled) Bottles Nappies, wipes, and barrier cream (e.g., Sudocrem) Blanket and pillow Preferred nap schedule (if any): Feeding instructions: Carry bag for dirty clothes TODDLERS (1–3 YEARS) Please Bring: Spare clothes (labelled) Lunchbox and drink bottle Nappies and wipes (if not yet potty trained) Pillow and blanket for nap time Personal toy (optional – for comfort) Potty training status:In ProgressTrainedPreferred learning or play style: option ID Do INCLUSIVE PROGRAM (ALL AGES) Please share: Diagnosis (if any): Type of support needed (e.g., speech therapy, visuals, routines):Communication method: VerbalSign LanguageHand GesturesOtherPlease ListTriggers/soothing techniques used at home: Staff may contact you for an individual education/behavior plan. KINDERGARTEN (4–6 YEARS) Please Bring: Backpack with lunchbox Drink bottle Change of clothes Small pillow for rest time Observations: SECTION 5: DOCUMENT CHECKLIST Please attach copies of the following: Birth Certificate of Child Drag & Drop Files, Choose Files to Upload Parent/Guardian Photo ID Drag & Drop Files, Choose Files to Upload 1 Passport-Sized Photo of Child Drag & Drop Files, Choose Files to Upload SECTION 6: CONSENT & SIGNATURE Do you give consent for MEC to take pictures of your child and use on our social media platforms such as our Website, Facebook, Instagram and YouTube? *YesNoYou may ask us to remove any social media post that you do not find appropriate at any time relating to your child.Click Link to view our policy. MEC Policy Declaration *I hereby declare that the information provided is true and complete. I agree to follow MEC's policies and give permission for my child to participate in all age-appropriate activities.Signature of Parent/Guardian: * Clear Signature Upload Electronic Signature Drag & Drop Files, Choose Files to Upload (optional)Date: *"Let us know how you heard about Milestone Education Centre by choosing an option below." *FacebookInstagramYouTubeFlyerNewspaperFrom a FriendSocial Media AdsSubmit Registration
