Information Form for A Heart for Children Early Learning Centre.

INFORMATION FORM

This is a general information form so that we at Heart for Children Early Learning Centre can get to know you and your child or children. Please fill out all sections so that we have a complete history for each child.

Child Information

What class will your child be attending?





Emergency Contact Information

This is a person who could come to pick up your child in the case of illness or emergency, if the school is unable to reach the parent or guardian. This authorized person needs to be local and able to quickly pick up your child - they will be required to provide picure identification at the time of pick up.

Language(s) Spoken in the Home

In order for the teacher to better understand your child, we would like to know about languages spoken around the child's home.

Child's Medical Information

Are your child's immunizations up-to-date?




Emergency Medical Authorization

I authorize the staff of A Heart for Children to administer first aid as required and to have my child transported by ambulance for medical treatment in an emergency. The parent/guardian would be contacted immediately. Parents/Guardians are responsible for the cost of any medical assitance such as ambulances.

Child Development & Support Needs

Does your child currently have any identified developmental or learning support needs?




If applicable, please indicate areas where your child may benefit from additional support:










Primary Parent/Guardian Contact

Secondary Parent/Guardian Contact

OUR POLICIES

By choosing YES or AGREE to any of the policies below, the parent/guardian acknowledges their acceptance and understanding of each of these policies, which are described in detail in the Parent Handbook.

Permission To Screen

"I give my permission for my child to be screened by the early intervention team." A Heart for Children Early Learning Centre provides early intervention screening to identify developmental areas in which your child may require additional support such as speech and language, fine or gross motor and/or regulation. The screening determines if early intervention services may be recommended for your child.


"If need is determined, I give my permission for my child to be assessed by the early intervention team."




Qualification for Alberta Education early intervention funding is based on assessment results. Do you give permission for AHFC to apply for early intervention funding if your child qualifies for support?


"I give permission for information, strategies and IPP documents to be shared with my child's partnering daycare, if applicable."


Child Release Policy

No child will be released to a person other than a parent without authorization.




Late Pickup Policy

If you or an authorized person has not picked up your child within 15 minutes of the end of class, we will call:

  • Primary Contact' cell
  • Secondary Contact cell
  • Emergency Contact
After one hour, we will call Social Services Child Protection department.




Evacuation Procedure

Should there be a situation where the school must be evacuated, the children will be taken to the designated Emergency Evacuation Site. Parents will be contacted to pick up their children as soon as possible.




Illness Policy

If a child exhibits signs or symptoms of illness at school, the parent/guardian or emergency contact will be called to pick up the child as soon as possible. This includes persistent cough, runny nose/nasal congestion, vomiting, diarrhea, rash, unusual tiredness.

Illness Policy




Provision of Health Care

A Heart For Children provides first aid care only, unless written consent and direction has been received from the child's parent/guardian to provide prescribed medical interventions.Do you agree with this policy?




Permission - Outdoor Activities

My child may be taken outdoors for supervised activities and neghbourhood walks by AHFC staff.




Permission - Photos

A Heart for Children Early Learning Centre (AHFC) may take photographs and/or videos to document learning, communicate with families, and share information about our programmes. Please indicate your consent for each category below.

Educational/Classroom Use - learning documentation, classroom displays, portfolios, assessment, and staff planning, newsletters, emails, classroom updates, or secure parent communication platforms.


AHFC Website - programme information, activities and school highlights.



AHFC Social Media - AHFC Facebook, Instagram and other official social media acounts.


Promotional & Community Materials - brochures, posters, presentations, fundraising materials, grand reports and advertisements.