Register For Play & Learn Preschool

Little Kid Doing Handstand in Canmore, AB

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Registration is on-going and be advised, space is limited. Please complete the registration form on this page.

For more details on our programs, or if you have any issues or questions, please do not hesitate to reach out to Ayisha Raja-Qadri, Administration at (825) 558-8078.

"*" indicates required fields

Please Select a Start Date*

Child's Information

Child's Full Name*

First Middle Last

Gender*

Male

Female

Date of Birth*

Parent / Guardian 1

Name*

First Last

Email*

Enter Email Confirm Email

Primary Phone*

Alternate Phone

Address*

Street Address City Province Postal Code

Parent / Guardian 2

Name

First Last

Enter Email Confirm Email

Primary Phone

Alternate Phone

Address

Street Address City Province Postal Code

Emergency Contact Information

Emergency Contact Name*

First Last

Relationship To Child*

Primary Phone*

Email*

Enter Email Confirm Email

Address*

Street Address City Province Postal Code

Person Who Has Permission To Pick Up Your Child

Name

First Last

Phone

Relationship to Child

Child's Medical Information

Alberta Health Care Number (FOIP)*

Allergies

Has Your Child Had A Recent Vision Test? If So, Date?

Has Your Child Had A Recent Hearing Test? If So, Date?

Is your child on any ongoing medication? If yes, please explain:

Are you currently seeking further support for your child for a concern that has been brought to the attention of a medical professional (family physician, pediatrician or psychologist)?*

Yes

Please explain what further support you are seeking.*

Additional comments or concerns you feel that Play & Learn staff should be aware of.

My Child's Immunizations Are Up To Date*

Yes

Consent for Emergency Care

In the event of an accident, I give permission to Play & Learn Preschool’s staff to contact Emergency Medical Services and if deemed necessary transport my child to a medical facility at my expense. I give permission for my child to accompany his/her class to the muster point. I give permission for my child to accompany his/her class offsite in case of an emergency. I declare that the information contained in this "Health Record" is true and correct.

Parent Signature*

Session Preference

Preferred Session*

Morning

Afternoon

Please Date & Sign

Name*

First Last

Parent Signature*

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Phone

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Register For Play & Learn Preschool

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Child's Information

Parent / Guardian 1

Parent / Guardian 2

Emergency Contact Information

Person Who Has Permission To Pick Up Your Child

Child's Medical Information

Consent for Emergency Care

Session Preference

Please Date & Sign

1205 1 Ave, Canmore, AB

playandlearn@maxecs.org

825-558-8078