CAPE OSC 2025-2026

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CAPE OSC 2025-2026

Please note that all fields MUST be completed according to Child Care Licensing Regulation

Email *

CHILD’S FULL LEGAL NAME

BIRTHDATE

AGE as of Aug. 30, 2025

GRADE

Kindergarten

Grade 1

Grade 2

Grade 3

Grade 4

Grade 5

Grade 6

Grades 7 (student must be 12 years of age or younger at registration)

CHILD’S PHYSICAL ADDRESS including city and postal code (no box numbers)

ALBERTA HEALTH CARE NUMBER *

DOCTOR'S NAME *

DOCTOR'S PHONE NUMBER
*

ALLERGIES OR MEDICAL CONCERNS *

PARENT 1 NAME & RELATIONSHIP *

PARENT 1 ADDRESS including city and postal code (no box numbers) *

PARENT 1 HOME PHONE NUMBER *

PARENT 1 CELL PHONE NUMBER
*

PARENT 1 WORK PHONE NUMBER
*

PARENT 1 EMAIL (checked regularly) *

PARENT 2 NAME & RELATIONSHIP

PARENT 2 ADDRESS including city and postal code (no box numbers)

PARENT 2 HOME PHONE NUMBER

PARENT 2 CELL PHONE NUMBER

PARENT 2 WORK PHONE NUMBER

PARENT 2 EMAIL (checked regularly)

EMERGENCY CONTACT 1 NAME & RELATIONSHIP: *

EMERGENCY CONTACT 1 ADDRESS (including city and postal code)
*

EMERGENCY CONTACT 1 PHONE NUMBER:
*

EMERGENCY CONTACT 2 NAME & RELATIONSHIP:
*

EMERGENCY CONTACT 2 ADDRESS (including city and postal code)
*

EMERGENCY CONTACT 2 PHONE NUMBER
*

Names of all persons (16 years of age or older) that your child may be released to. Please include parent(s) names and all adults and siblings who may be picking up your child.

Are your child’s/children’s immunizations up to date?

Yes

Does your child suffer from asthma, allergies or anaphylaxis?

Yes, please make an appointment to complete an emergency medical plan for your child before he/she attends care.

Is there any special medical information other than listed above that we should be aware of?

Are you aware of any behavioural issues that may affect the safety or well–being of the other children in the program?

Do you give permission for the school staff and the CAPE Out-of-School program staff to share information about your child (homework, attendance, illness, etc.) to better support your child? Without this permission, caregivers are unable to support school programming.

Yes

Is there any other information that you feel we should know about your child? Fears, habits, likes/dislikes, etc:

CAPE BEFORE & AFTER SCHOOL PROGRAM 2025 - 2026 PARENT CONTRACT

Between yourself (parent) and CAPE School, whereas CAPE School operates the CAPE Before & After School Program; and the parent(s)’ desire to register their child/children for the CAPE Before & After School Program.

NOW THEREFORE, THIS PARENT CONTRACT WITNESSES THE FOLLOWING SECTIONS:

REGISTRATION PROTOCOL

The Parents hereby certify and agree that the child is in their lawful custody, and that there are no other persons whose consent is required for the enrolment of the child in this program. Children will only be released to people authorized on the child’s registration form by the parent or in a written note signed by the parent.

I agree.

PROGRAM OPERATION

The program will take place in the school; classrooms and gymnasium. The CAPE Before & After School Care Program is solely responsible for the supervision of the children within their care. Before School Care begins at 7:00 am and children must be on the schedule as provided by parents. For After School Care, kindergarten children attending the program will be picked up from their classrooms at 3:15 Monday – Thursday and 12:15 on Friday. Children in grades 1-6+ are expected to be at the Program meeting place by 3:40 p.m. on regular school days, and by 12:15 p.m. on Fridays. In the event that a child has not been brought into before school care (left unattended outside), or has not been picked up by 5:40 p.m., the staff will make every effort to contact the parent(s) or the alternate emergency contact before calling Emergency Child Welfare.

The program will not operate on school holidays, which include Professional Development Days, Christmas break, Teacher’s Convention, Easter Break, and any other days that may arise.

I have read and understand.

HEALTH CARE & MEDICAL ISSUES

In the event of a life threatening medical emergency, the staff reserves the right to engage emergency medical assistance for the child. All costs associated with a medical emergency shall be borne solely by the parents. The parent must consent to the program administering health care or health care in the nature of first aid. Staff will be authorized to administer only life-saving medications (specifically inhalers and/or Epipens) as per written directions provided by the parent(s). There will be no other exceptions to this. If a child is ill, the parents or emergency contact will be contacted and the child must be picked up immediately.

I have read and understand.

NUTRITION

Students are expected to bring snacks during the week as well as lunch on Fridays. Snacks will not regularly be provided by the program. Students who require food may access the school food program.

I have read and understand.

DISCIPLINE/BEHAVIOUR ISSUES

The Before & After School Program reserves the right to cancel this contract immediately if there is a severe discipline problem that is affecting the well being of the staff, other children, the program or if the child is a danger to him/herself. Please be aware that we are not discriminating against children with behaviour issues, we just do not have the staff, the resources or training required to give the necessary one on one (1/1) attention.

I have read and understand.

PAYMENT OF FEES

The annual non-refundable registration fee of $35.00 per family is required for admission into the program.

Monthly payment is due PRIOR to children attending care. Please note that online payments may take up to 3 business days to process. In-office payments may take up to 48 hours to process. Cheques are to be made payable to CAPE School. A service charge of $15.00 will apply for all NSF cheques.

A receipt for income tax purposes will be issued by request. There will be a $5.00 fee for issuing duplicate receipts.

I have read and understand.

REGISTRATION FEE

How would you like to pay the $35 annual registration fee? There is only 1 registration fee per family per year.

Lillio (EFT or Credit Card)

Cheque/Cash at the office

Please indicate which billing/usage applies to your child:

NOTE: OSC hours apply to any care provided either before or after school.

Prepaid Full Time Care - coverage 25+ hours per month ( $360)

Prepaid Part Time Care - coverage up to 25 hours per month ($225) Should families go over their prepaid times, they will be billed at $10/hour for the overage with the following month's invoice.

Prepaid Sporadic Use tab - coverage for up to 10 hours throughout the year ($150/10 hours) Should families go over their 10 hour tab, a new tab will be billed.

Billing Subsidy: Please note that our program will bill subsidy at $10/hr based on your child's program usage, up to $360 (full time). Whatever usage fees are not covered by subsidy will be billed to the family. Please note that full-time hours at our program (25+/month) are not the same as full-time hours by subsidy standards (50+/month). Please contact the subsidy office regarding your usage and coverage.

LATE PICK UP

Parents must sign out each child on individual Child Attendance Forms when picking up their child(ren) from the after school program. A signature of parent or authorized caregiver to whom the child may be released to and the time the child has left the program must be included when signing out. If there is no specific time indicated, it will be assumed that your child(ren) used the program until 5:30 p.m. and you will be billed accordingly. For each late pickup per family, there will be a $10.00 fee per half hour or part thereof after the designated program closure time.

I have read and understand.

INFORMATION, QUESTIONS & CONCERNS

Program information can be found on HiMama as well as posted in the Learning Commons in the school.

Any questions, concerns or complaints about the CAPE Before & After School Program should be directed, in writing, to the Program Supervisor, Mrs. Gordon, for review. A written response will be submitted to the parent within two weeks of the written application being received.

I have read and understand.

CONTRACT RIGHTS

Parents have the right to cancel this contract with two (2) weeks written notice. The CAPE After School Program reserves the right to cancel this contract any time with two (2) weeks notice if, in its discretion, it is deemed to be held in the best interests of the child or the program.

I have read and understand.

I understand that once this form and deposit are paid, processing takes 24-48 hours before my child(ren) can attend care. Due to the steps required to meet licensing requirements, applications cannot be processed in one day.

By typing my signature, I am agreeing the above contract and ensure the information is accurate.

Send me a copy of my responses.

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