2021-22 Pre-K or Nursery

STUDENT INFORMATION

Full-Name: *

First

Middle

Last

Gender: *

M
F

Date of Birth: *

Age: *

Address: *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

First Nations: *

Yes
No

Student is ESL (English as a Second Language)? *

Yes
No

Student is a Canadian Citizen? (copy) *

Yes
No

Upload citizenship confirmation: (birth cert. or valid passport) *

Please indicate: *

Permanent Resident/Landed Immigrant
Temporary Resident (Please provide proof of residency status)

Birth Country, if not Canada *

Upload valid passport: *

PROGRAM INFORMATION (All fees are monthly, if you prefer a different payment arrangement, kindly indicate in the notes field at the bottom of the form.)

Grade Level: ($25 reduction for Livingston HOA/Brookfield Communities) *

PreK Half-day AM 9:00-12:00pm $350

FULL: PreK Half-day PM 12-3pm $350 & Full-day 9-3pm $650

PARENT/GUARDIAN INFORMATION

Parent/Guardian 1

Full Name: *

First

Last

Relationship to student: *

Address, same with student? (Parent 1)

Yes
No

Enter Address: *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone: *

Email: *

Parent/Guardian 2

Full Name: *

First

Last

Relationship to student: *

Address, same with student? (Parent 2) *

Yes
No

Enter Address: *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone: *

Email: *

EMERGENCY CONTACT (Does not include one of the parents)

Full Name: *

First

Last

Phone: *

Email: *

ADDITIONAL INFORMATION

Any form of allergies that we need to be aware of (please list or specify): *

Is your child on routine medication that must be taken while at school? *

Yes
No

If yes, please explain: (routine medication)

Immunization up-to-date? *

Yes
No

If no, please explain: (immunization) *

Do you believe your child is showing symptoms of speech, OT or other delays? *

Yes
No

If yes, please explain and include any intervention/support done in the past:

TERMS AND CONDITIONS

I understand that monthly school fees will be debited from my account every 1st of the month for the entire school year, from September 2021 to June 2021 and will abide to this year’s contract. For unforeseen events that my child is required to be transferred to another school I agree to give a month’s notice by the 1st of the month in writing. It will be the school’s decision to honor my request on a case to case basis. Notice given after the 1st of the month will result in full fees for the next calendar month.
It is my responsibility to inform the school for any changes to our address, phone numbers (home & work) emergency contacts, or anything that maybe important concerning the well-being of my child (i.e. illness/death in the family, divorce or separation etc.)
It is my responsibility to inform the school daily (school app) if my child is sick until the child returns to school and to keep my child at home if showing symptoms of vomiting, has a fever or diarrhea, or has an excessive cough, or anything contagious like “pink eye”.
It is my responsibility to inform the school if my child is expected to be away for longer than 3 days at any time other than during winter or spring breaks. NO refunds for absences or extended leaves (i.e. vacations).
I give permission for the staff at Calgary International Academy to treat my child for minor injuries (i.e. first aid) and to call for appropriate medical support (ambulance, poison control, etc.) in case of serious injuries that requires immediate care and hospitalization.
A charge of $50CAD for NSF payments per transaction and payments in default may result in cancellation of services.
I authorize the school to use my child’s pictures, videos or any form of media for promotional purposes.

I agree to the terms of this contract, including the Fees Policy for school year 2021-22, and Parent’s Handbook/Policies and Procedures.

Non-refundable registration fee: *

New student $100
Returning student $50

Upload voided cheque: (monthly fees and registration fee) *

Notes: