Online Registration

KELC Daycare provides an easy way to get your child registered here through our Online Registration & Health form.

KELC Online Registration Form

Welcome to the KELC Online Registration & Health form. Please go through and fill in all the pertinent information we require in order to register your child for the programs we offer.

Starred (*) fields are required.

Child’s Full Name:*
First Last
Child's Nickname Used:
Child's Birthdate:*

Day
Month
Year
Program Start Date:*

Day
Month
Year
Program Required:*
- Multi age (0 – 6 years of age)
- Daycare 30 months to School age
- Infant/Toddler (0 – 36 months)
Do you require Subsidy?*
- Yes
- No
Child's Gender:*
- Male
- Female
Parents/Guardian (please list both parents):*
Email (please provide one that is checked regularly):*
Enter Email Confirm Email
Home Address:*
Street Address Address Line 2 City Province Postal Code
Home Phone:*
Mom’s Work Address:
Street Address Address Line 2 City Province Postal Code
Mom’s Work Phone
Dad’s Work Address:
Street Address Address Line 2 City Province Postal Code
Dad’s Work Phone
Alternate Emergency Contact Name:*
Alternate Emergency Contact Phone:*
Alternate Emergency Contact Relationship to Child:*
Others Authorized to Pick Up the Child:*
Click the + button to add more persons.
Person(s) Prohibited From Accessing the Child and Relationship to Child:*
Click the + button to add more persons.
Name Relationship
Care Card #:*
Family Doctor Name:*
First Last
Family Doctor Address:*
Street Address Address Line 2 City Province Postal Code
Family Doctor Phone:*
List any known health concerns, including allergies and instructions to follow in the event of an allergic reaction and reaction type:*
Immunization Record:*
- Yes, my child’s immunizations are up to date (Please provide child’s health passport)
- No, my child’s immunizations are not up to date
Parent/Guardian Consent: Please fill in your name, your child’s name, and initial each box to indicate your consent for each of the following situations.*
I,
hereby give Kaleidoscope Early Learning Centre consent for the following in regards to my child,*
named
Consent to Travel:*
I give my consent for the caregiver to take my child on field trips. I understand that they may travel on foot, or in a motor vehicle and that the caregiver has appropriate vehicle insurance and will adhere to all laws regarding transporting children safely, or public transport. Notification will be given in advance if travel via motor vehicle or public transport is to occur.
- Yes
Consent to Emergency Medical Care:*
I understand that it is the caregiver’s policy that the parent/guardian be notified when a child is ill or needs medical attention. If I can’t be contacted and immediate help is needed, I consent for an ambulance to be called, or my child to be taken to the nearest emergency service where they may receive necessary medical treatment. I understand if parent/guardian is contacted to puck up child this must occur with in 30 mins of notification.
- Yes
Consent to take photographs:*
I give my consent for photographs of my child to be taken by the caregiver. I understand that these photographs will only be used in the Kaleidoscope Early Learning Centre setting and on closed social media groups only for family of Kaleidoscope Early Learning Centre.
- Yes
Consent to administer medication:*
I herby give consent too Kaleidoscope Early Learning Centre to administer prescription and / or Over the Counter medication to my child. I understand that the medication(s) must be in the original container with the pharmacist/original label attached. The children’s centre will follow and adhere to the labeled instructions.**Consent to Administer Medication Form; needs to accompany any and all medications**
- Yes
Terms and Conditions*
By signing this application form you agree to the terms and conditions as set forth by The KELC Daycare Parent Handbook (.pdf). You further agree with the philosophy, principles, values and guidance policy at Kaleidoscope Early Learning Centre ( Currently using KELC handbook). Children are taught and cared for in a caring and loving manner. They will be given every opportunity to challenge themselves and discover learning in a positive and proactive way. These methods are encouraged to be further developed at home. By signing this letter you understand and agree that your child’s spot will be held and that you are aware of the $100 non-refundable registration fee. Check "Yes" indicating you have read the deposit requirements
- Yes
Signature*
Relationship to child:*
Date*
DD slash MM slash YYYY
Name
This field is for validation purposes and should be left unchanged.

Printable Registration Form

If you would like to fill out and submit a conventional registration form, click the button below. When you open this .pdf file print it off, fill it in and then bring it with you when you come in to register your child for our programs.

PDF Registration & Health Form

Our Privacy Policy

To Our Families:

Your privacy is important to us, and maintaining your trust and confidence is one of our highest priorities. We respect your right to keep your personal information confidential.

We collect certain personal information about you and your family – but only when that information is provided by you or is obtained by us with your authorization. We use that information to prepare your child’s registration for LSMVC Daycare at your request.

This information will be kept strictly confidential and will only be used for the internal purposes of maintaining the required records as set forth by the Interior Health Authority – Child Care Regulations Act. During routine inspection conducted by a Licensing Office of the Interior Health Authority your information will be reviewed to ensure that all regulations are being met.

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Latest News

2020 Program Changes

Aug 24, 2020 | News

Currently KELC Daycare is going through a change in philosophy and the approach to this philosophy. We will be updating our website shortly. Please feel free to reach out to the facility for information on programs and availability.

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KELC Daycare

1555 McLean Street, Trail, BC, V1R 1Z1
Phone: +1 (250) 368-6789
Fax: +1 (250) 368-6778
Email: contact@trailchildcare.com

Name	Relationship