*Last Name
*First Name
*Hebrew Name
*Gender Male Female
*Date of Birth
*Address
*City
*Province
*Postal code
*Home Phone
Previous School
Group Child with (no guarantees)
*Physician Name
*Physician Phone
Insurance
*Ohip Number
*Allergies
Medical Note
*Title --Select Title-- Mr. Dr.
*Work Phone
*Cell Phone
*Email
*Title --Select Title-- Mrs. Ms. Dr.
Work Phone
*Marital Status --Select -- Married Seperated Divorced Single
*Affiliation --Select -- Adath Israel Beth David Beth Jacob - Hamilton Beth Radom Beth Shalom Beth Torah Beth Tzedec Darchei Noam Family Shul - Chabad Forest Hill Jewish Centre Holy Blossom Oraynu Cong. Shaarei Shomayim Shaarei Tefillah Temple Emanuel Temple Sinai Village Shul None Other
Have there been adoptions or conversions in the family?
If yes, please explain
Name Phone # Relation
*Emergency 1
*Emergency 2
Please choose enrollment options
*Tuition --Select-- Infant/Toddler (9-2:55pm) Jr. Nursery (9-11:30am) Jr. Nursery (9-2:55pm) Nursery (9-1pm) Nursery (9am-2:55pm) Kindergarten
Total Amount:
Deposit charged now. Payment schedule: Jan 1, February 1, March 1, 2024. All payment are non-refundable/transferable once paid.
For credit card payments, a 3% fee will be added. If paying by cheque, please drop off the deposit and post dated cheques at our office to secure your child's spot.
.
Card Type --Card Type-- Visa MC
Card Number
Expiration Date --Month-- 01 02 03 04 05 06 07 08 09 10 11 12 --Year-- 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036
Security Code
Use Information above
Name on Card
Billing Address
Billing Zip code
Upon registering your child, a non-refundable deposit will be charged to your credit card. This deposit goes toward tuition. Once your child is accepted into the program we require post dated cheques mailed or dropped off or you can opt to pay by credit card which will be charged as per the payment plan (3% credit card processing fee applies.) Please see the Tuition Schedule for the payment plan. Please note that there are no tuition credits or make up days for illness, holidays or family vacations. We require a one-month notice in writing if it becomes necessary to withdraw your child from the preschool. At that point your remaining post-dated cheques will be returned to you or we will cease to charge your credit card. The deposit and all fees paid are Non-Refundable and Non-Transferable, no exceptions. Please click the box to acknowledge that you accept the terms and conditions of our Payment and Refund policy. We will be contacting you via SMS occasionally.
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