432 Runnymede Road
Toronto, Ontario M6S 2Y8
(416) 767-6729

Application for Enrollment
Child’s First Name Child’s Surname(s)
Date of Birth (DD/MM/YY) Admission Requested (Month/Year)
Address
City Postal Code Home Phone
Mother’s Name Occupation Home Phone
Name and Address of Employer Business Phone
Father’s Name Occupation Home Phone
Name and Address of Employer Business Phone
Family Physician Doctor Phone
Address Child’s Health Card Number
Emergency Contact #1 Relationship Contact #1 Phone
Emergency Contact #2 Relationship Contact #2 Phone
Is there any medical condition of which we need to be aware? If so, please describe below:
In the event of an accident, may we take your child to the hospital? Yes or No
May we circulate your name, address and phone number to other BWNS parents? Yes or No
I have read the information brochure and I agree to the terms as outlined therein. Enclosed is the non-refundable registration fee of $100 to secure a space for my child. Applications must be signed by both parents/guardians, except in the case of single parents, and must be accompanied by the fee.
Mother’s Signature Date
Father’s Signature Date

 
To help us get to know your child, we ask you to provide some background information. All information is confidential. Please inform the teacher if any circumstances change.
Medical Background No Yes

Particulars
Asthma?
Diabetes?
Epilepsy?
Hyperactivity?
Allergies? (Be specific)
Any other medical conditions?
Any daily medications?
Any disabilities?
Family (Brothers and Sisters) 
Name and Age Name and Age
Name and Age Name and Age
Persons to Whom Child May Be Released 
Name Relationship to Child (nanny, friend, grandparent, …)
Name Relationship to Child (nanny, friend, grandparent, …)
Child’s Interests 

What are some of your child’s interests? (ex. Puzzles, books, colouring, games, television, ….)
 
 
 
 
Toilet Habits

Please indicate your child’s toilet habits. If your child is not trained, how would you like to assist us?
 
 
 
 
Additional Information on your Child
 
 
 
 
 
Provincial regulations require a signed medical form for each child in a Nursery School. Therefore the enrollment of your child in BWNS will be considered complete only when the medical form as well as the application and deposit are received by BWNS. The medical form may be returned subsequently to the application but must be submitted prior to the first day of school. The enrollment of any child in BWNS may be reviewed by the Board of Directors should such a review be deemed necessary.