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       Kingston Montessori School -- Summer of 2008
          "Summer Fun" Registration Form Page 2

Emergency contacts: in case of emergency and neither parent can be contacted, the following
people have my permission to pick up my child from school, or to meet my child at hospital:

_______________________________________ Phone: home: ____________ work: ___________

Relationship to my child: ________________________________________________

KMS has my permission to transport my child to an emergency treatment centre in the event that
it is necessary. I will be called to meet my child and staff member at the hospital:

Signed: __________________________________________

Allergies and reactions :________________________________________________

Applying for (please check all that are requested)
 Week 1 (June 30 - July 4) .................................. "Canada Rocks!" (4-day week)   .........  $  80
 Week 2 (July 7-11) ............................................. "Science Art"   .........  $100
 Week 3 (July 14-18) ........................................... "Kids in the Kitchen"   .........  $110
 Week 4 (July 21-25) ........................................... "Story Telling Week"   .........  $100
 Week 5 (July 28 - Aug 1) ................................... "Mighty Machines"   .........  $100
 Week 6 (Aug 5-8) ............................................... "Wet and Wild" (4-day week)   .........  $  80
 Week 7 (Aug 11-15) ........................................... "Colour Week"   .........  $100
 Week 8 (Aug 18-22) ........................................... "Wilds of Africa Week"   .........  $100

All children are accepted on the basis that their behaviour will not be detrimental to
the group. If behaviour becomes intolerable or violent, the parent will be asked to
remove the child from the KMS Summer Fun Program. No refund of fees will be given.

Signature of parent or guardian: _____________________________ Date: _______________

         ** Please also fill in page 1 of this form **

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Office use only:  Date received: ______________________________
Cheques received: ____________________________________________________________________
Comments:__________________________________________________________________________
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