Office Hours: Monday-Friday 8:30am - 4pm | Phone: 250.550.4471 |
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info@appletreechildcare.ca
Welcome
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Preschool
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Registration
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Transportation Permission
Care Plan for Allergies
Medication Permission Slip
Handbook – Preschool
Handbook – After School Care
Fees
Fee Schedule
Registration Fee
Contact
Welcome
Services
Preschool
After School Care
Summer Care
Registration
Summer Registration
Transportation Permission
Care Plan for Allergies
Medication Permission Slip
Handbook – Preschool
Handbook – After School Care
Fees
Fee Schedule
Registration Fee
Contact
Emergency Card Form
Home
Emergency Card Form
Emergency Card Form
deejay23
2018-02-14T18:00:59-08:00
Emergency Card
Child's Name:
*
First
Last
Please upload a good identification photo of your child. (You can bring one in to Appletree if you are unable to upload for some reason.)
Accepted file types: jpg, gif, png, pdf.
Child's Eye Color:
*
Child's Hair Color:
*
Child's Date Of Birth:
*
Date Format: MM slash DD slash YYYY
Parent/Guardian 1:
*
First
Last
Parent/Guardian 1 Email:
*
Parent/Guardian 1 Phone:
*
Parent/Guardian 1 Alternate Phone:
Parent/Guardian 2:
First
Last
Parent/Guardian 2 Email:
Parent/Guardian 2 Phone:
Parent/Guardian 2 Alternate Phone:
Emergency Contact Person:
*
First
Last
Emergency Contact Person Phone:
*
Emergency Contact Person Alternate Phone:
Doctor:
*
First
Last
Doctor Phone:
*
Child's Care Card Number:
*
Child's Allergies, Medications or Concerns:
Approved Pickup Other Than Parent - FULL Name & Relationship
Signature
*
By signing here you give permission for your child to be transported by ambulance in case of an emergency.
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