Little Rascals maintains stringent policies in regards to child pick-up from the Childcare Facility. Detailed Information is required of all persons, from parents or guardians with legal custody of the child, to other individuals nominated by the parents or legal guardians to pick up the child from Little Rascals. The safety of the child is our number one concern in this regard. The required personal information will remain private and will only be available to Little Rascals Staff and appropriate licensing and law enforcement authorities upon request.

• Note 1: If parents are separated, divorced or otherwise estranged then a copy of a court order or other legal document detailing custodial arrangements must be supplied to Little Rascals.
• Note 2 : If custody of the child is with anyone other than biological or adopted parent(s) of the child, then copies of the proper documentation must be provided to Little Rascals.

Parent / Guardian #1  (With Legal Custody of Child)

Parent / Guardian #2  (With Legal Custody of Child)

Medication : Does your child require medication while at Little Rascals?
If yes, please note that you must request and fill out a Request for Administration of a Medication or Alternative Medicine.

Immunization Record: The Vancouver Coastal Health Unit requires all parents or guardians seeking admission to provide a statement of their child's immunization record.

You will be required to submit confirmation of immunization upon acceptance.
Note : It is strongly recommended by the Health Authorities that your child has immunization protection unless there is a medical reason not to do so.

Note : If your child requires specialized care for a special needs issue, a qualified care worker may first have to be provided to Little Rascals through Supported Childcare before your child can attend. If applicable, please discuss with the Director of Little Rascals.

Little Rascals Daycare and Little Rascals Preschool form part of and are managed by Little Rascals Daycare Ltd. The use of the name "Little Rascals" or any of the above variations on the name "Little Rascals" in this permission form shall be understood to mean Little Rascals Daycare Ltd.

With all rights at law to enroll my child in a Little Rascals program, and in consideration of the Little Rascals accepting and caring for my child, I do acknowledge and agree with all of the following:

1. I have received, carefully read and understand the Little Rascals Registration Form including the terms of Admission
   and I do agree with the policies, procedures and conditions laid out herein;
2. I understand that the Little Rascals has the right to refuse service to my family if I am in breach of this contract;
3. I have received, read and understand the Little Rascals Policy and Procedures Manual and I do agree with the policies,procedures and conditions laid out herein;
4. I have made full disclosure to Little Rascals regarding all medical / Health conditions or issues pertaining to my child as requested or indicated in the registration form.
5. I have made a full disclosure to Little Rascals in writing of a physical condition, special needs, challenges or disabilities that affect my child;
6. I understand that in regards to Supported Childcare (special needs care), it is not the responsibility of the Little Rascals to hire staff for the purpose of providing Supported Childcare but rather the responsibility of the client to coordinate this with the appropriate government agency.
7. I have made full disclosure through the Little Rascals Registration, or in any other written form, of any behavioural
   conditions, patterns or issues that Little Rascals Staff should be aware of in order for Little Rascals to properly and safely provide quality care for your child and the other children in his/her childcare program(s).
8. Little Rascals may, at its own discretion, from time to time make changes to its information packet, Childcare Brochures, Registration guide, Registration Policy, Registration Forms or its policy and procedure manual.
9. I hereby give permission for my child to attend all walking field trips while enrolled at Little Rascals;
10. I am ultimately responsible for the payment of fees to Little Rascals for the child I am registering; on or before the 1st day of that month
11. Payments can be made by e-transfer.
12. Little Rascals reserves the right to change its fees from time to time. Notices will be posted at least one month in advance of any such change
13. In the case of absenteeism (including illness, vacations and holidays), the fee is still due and all parts of this contract still apply;
14. A Deposit of one month's fees must be paid to Little Rascals prior to the start of enrollment. The deposit will be kept until the client's last month of enrollment at which time the deposit will be applied to the last month's fees or refunded to the client if the last month's fees have been paid. The deposited will be forfeited to Little Rascals for non-compliance of this contract;
15. Prior to leaving Little Rascals, the client is required to give a minimum of 2 months written notice to the Director. Failure to give proper notice will result in the client forfeiting the deposit.
16. Little Rascals reserves the right to refuse service to clients with fees outstanding beyond 14 days;
17. Little Rascals will charge the client $20 for each payment returned to Little Rascals due to insufficient funds (NSF)