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       Kingston Montessori School -- Summer of 2008
          "Summer Fun" Registration Form Page 1

1134 Johnson Street, Kingston ON K7M 2N7, Canada
613 541 1275   fax: 613 389 5309   e-mail: kmsadmin@bellnet.ca

Child's Name ________________ _______________ ______________________ _____________
  First Middle Last Nickname

Male     Female       Birthdate: month____________    day____________    year_________

Child's home address ___________________________ __________________ ______________
  street address city postal code

Phone Number:    ________________________
===============================================================================
Mother's name: __________________________   Phone: same as child's    or ____________
Address: same as child's  or: ____________________________________________________
Occupation: ______________________________________________
Place of work: address: __________________________________________________________
Work phone number: _______________________   Cell phone: _________________________

Father's name: ___________________________   Phone: same as child's    or ____________
Address: same as child's  or: ____________________________________________________
Occupation: ______________________________________________
Place of work: address: __________________________________________________________
Work phone number: _______________________   Cell phone: _________________________
===============================================================================
Previous pre-school experience: __________________________________________________
Siblings -- names and ages: ______________________________________________________

FEES: $10 Registration Fee per family
Fee for Weeks 2, 4, 5, 7 & 8: $100
Fee for Week 3 (Kids in the Kitchen): $110
Fee for Week 1, 6 (4-day weeks): $  80

** Please also fill in page 2 of this form **

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