604-498-3233 | info@surreychristian.com | www.surreychristian.com

EARLY LEARNING REGISTRATION

Today's date * +

STUDENT DETAILS

Start date *

September 6, 2022

Other Other

Dear Parents and Guardians:

Children are natural learners and creation enjoyers of God’s world. Our mission at the Surrey Christian School Early Learning centres is to offer safe, diverse, experiential learning opportunities to recognize the full potential and individuality of each child. We believe each child is created in the image of God and has an important and unique role to play in sharing His redeeming love with the world around them.

We want to thank you for partnering with us, for entrusting your child to us as they begin their educational journey and for allowing us to speak truth and love into your child’s life. Our promise to all our parents is to educate for wholeness by engaging God’s world in the servant way of Jesus. Our hope is that your child begins to unpack all the gifts that make them completely unique as they become fully alive in God’s story at Surrey Christian School.

We invite you to submit the registration as soon as possible as space is limited. You will receive a welcome letter to confirm your child's acceptance into the Surrey Christian School's early learning program.

Director of Early Learning Programs, Ingrid Fritsch
Principal Tom Williams, Fleetwood Campus | Principal Patti Thomas, Cloverdale Campus
Early Learning Managers: Genny Buchanan, Cloverdale Campus | Jean Chen, Clayton Campus

Student legal first name *

Student middle name

Student surname *

Name child responds to (if different than legal first name)

Child's birthdate * +

Gender *

Male

Female

I would like my child to attend the early learning program at the following campus: *

Fleetwood Campus (8888 162 St)

Clayton Campus (18625 Fraser Hwy)

Cloverdale Campus (5950 179 St)

You will choose which class you wish to enroll your child in under the Financial Commitment section later in this form. The following options are available:

Fleetwood Campus (8888 162 Street)

Preschool & Jr. Kindergarten; 9:00 am - 1:00 pm

-Preschool Tues/Thurs for ages 3&4: $255/month
-Junior Kindergarten Mon/Wed/Fri for age 4: $310/month

Cloverdale Campus (5950 179 Street)

Daycare with preschool component; open from 7:00 am - 6:00 pm

-2 full days per week: $350/month
-3 full days per week: $520/month
-5 full days per week: $865/month

Preschool & Jr. Kindergarten; 9:00 am - 1:00 pm
-Preschool Tues/Thurs for ages 3&4: $255/month

-Junior Kindergarten Mon/Wed/Fri for age 4: $310/month

Clayton Campus (18625 Fraser Highway)

Daycare with preschool component, open from 7:00 am - 6:00 pm

-2 full days per week: $350/month
-3 full days per week: $520/month
-5 full days per week: $865/month

Language spoken at home *

Will you have other children attending Surrey Christian School in grades K-12 while your child is attending our early learning program? *

Yes

No

How did you hear about our school?

Is there someone we can thank for referring you to our early learning program? If so please provide a name and phone number.

HOUSEHOLD INFORMATION

Parent/guardian email address *

Household primary phone number *

The child lives with *

First and last name(s) of people authorized to pick up my child. *

If a court order has been made concerning the care/custody of the child please attach a copy when you get to the section that allows attachments to be uploaded.

Mother first name *

Mother surname *

Mother email address (if different than primary email address)

Mother's cell phone number *

Mother's work phone number

Mother occupation

Mother employer

Father first name

Father surname

Father email address

Father cell phone number

Father work phone number

Father occupation

Father employer

Is one or both parents an alumni of Surrey Christian School or Fraser Valley Christian High School? *

No

Yes

Family street address *

Unit/Apartment #

City *

Province *

Postal code *

NAMES OF OTHERS LIVING IN SAME HOUSEHOLD

Name

Relationship to student

Age

Gender

Male

Female

Name

Relationship to student

Age

Gender

Male

Female

Name

Relationship to student

Age

Gender

Male

Female

Use this space to add further household members

HEALTH

BC Personal Health Number *

Name of family doctor *

Doctor phone number *

Please specify any known allergies or medical conditions of which we should be aware. *

Is the student currently taking any medication on a regular basis? If yes please provide details. *

No

Yes Yes

EMERGENCY CONTACTS

Please enter at least 1 and up to 3 names of people who have authorization to pick up your child, or whom we can contact in the event of an emergency and we cannot reach a parent.

First and last name of emergency contact *

Relationship to student *

Comments

Phone number *

2. First and last name of a second emergency contact

Relationship to student

Comments

Phone number

3. First and last name of a third emergency contact

Relationship to student

Comments

Phone number

ADDITIONAL INFORMATION

If your family attends a church, please provide the full name of the church that you attend.

What are your child's interests? *

Has your child previously attended daycare/preschool? If yes, please provide some details. *

No

Yes Yes

Can your child dress and toilet him/herself? *

Yes

No

Comments

Please explain if there is anything else you want us to know about your child? (health concerns, speech, hearing or vision problems etc.) *

Are there any special family circumstances the school should know about? *

CONSENTS

Field Trip Consent

Acknowledgement of Risk

Students occasionally go on a walk through the neighbourhood. I have read the school's Acknowledgement of Risk form (link above) and consent to having my child go on supervised walks during the school year. *

Yes

No

Photograph Publishing Consent

Throughout the school year photographs are taken of various student activities. I consent to have the student’s picture published in the school newsletter, yearbook, publications or on our website. The school only publishes first names of students. *

Yes

No

Medical Treatment Consent

In case of an emergency where parents cannot be contacted I authorize the principal or school representative to contact the family doctor or take the necessary steps to ensure the health and safety of my child. *

Yes

No

Handbook

Please read through the Early Learning Parent Handbook. Click on the link below and scroll to the bottom of the page to download.

Early Learning Parent Handbook

I have read and understand the Early Learning Parent Handbook. *

Yes

Protecting Your Personal Information

Surrey Christian School collects and uses personal information for the sole purpose of maintaining accurate student records in the administrative offices, and to respond immediately to an emergency. SCS commits to using and storing this information responsibly and will not release this information to a third party without your verbal or written consent unless permitted under the PIPA (Personal Information Privacy Act) legislation. If you have questions about SCS’s use, storage or disclosure of personal information, please contact our privacy officer.

I consent to having SCS collect, use and disclose this personal information as outlined above. *

Yes

FINANCIAL COMMITMENT

Using the drop down menu choose desired class with applicable monthly fee. All prices reflect the government fee reduction initiative program. *

Please list an alternate choice if your requested class is full, and/or specific days you prefer.

Fee payment *

I will pay the fees in full on the first day of school

I will pay the fees monthly on the first of the month by pre-authorized payments. (Please click on the link below to complete the pre-authorized debit form if the school does not have one on file.)

Link to Pre-authorized Debit Form

Upon acceptance the following is due:

1. $40 field trip fee

2. First month's payment

These fees will be withdrawn from your bank account directly. Please be sure to complete the pre-authorized debit form (link above).

I understand that I will be charged a $75 change fee if I request a modification to my child's early learning registration (going from 2 days/week to 3 days/week etc.) *

Yes

Who will be paying the fees? *

Parent

Government subsidy (note there is always a parent portion that is required to be paid)

Other (please specify full name, phone number and email address) Other (please specify full name, phone number and email address)

I acknowledge my financial obligation to the school. If during the course of the school year I intend to withdraw my child I understand that I must give 1 month’s notice to the school at month-end, or pay 1 month of tuition in lieu of notice. *

Yes

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