Child Registration Package Updated January 2020

REGISTRATION PACKAGE INSTRUCTIONS

1. Save this package to your computer and label it “LastName of your Child, FirstName of your Child, SchoolName”

2. Open the file from your computer and fill out the form fields

3. Save your completed registration as a PDF.a. If you are registering more than one child, please save individual copies of your registrations.

4. Email your registration package(s) along with the completed “Pre-Authorized Debit (PAD) Form” and attach a scan of a void cheque made out to TOPP KIDS to registrations@toppkids.com or mail it to:

TOPP KIDS Out Of School Clubs#5918, 3rd Street SWCalgary, AB T2H 0H8

5. A confirmation email will be sent to you once your registration is complete.

2020 /2021 FEE STRUCTURE (Effective April 2020)

Parents are required to provide post–dated cheques or an PAD form for the entire school year at the time of registration.

Cheques and PAD payments must be dated for the 1st or 15th of every month. Payments for individual PD Days, Drop-Ins, or any miscellaneous charges will be made through PAD agreements or via cheque . TOPP KIDS does not accept cash payments.

Consent of Parent or Guardian, Release of Liability

& Acknowledgement of Risk & Policies (On & Off-Site Activities)

Form must be completed in full including all circles checked as read, signed and dated BEFORE

the participant can start attending a TOPP KIDS program.

Guiding Philosophy of TOPP KIDS Out of School Clubs:

The owners of TOPP KIDS Out of School Clubs will make every reasonable effort to ensure that: • Supervisors and staff of the TOPP KIDS programs are experienced and trained

• Children and youth participating in the program are adequately supervised

• The location and/or facilities meet the applicable health and safety standards

• All bus transportation will be provided by either Southland Transportation Ltd or First Canada Charter Ltd.

Warning: By signing this document you will waive certain legal rights, including the right to sue.

TO: THE OWNERS OF TOPP KIDS Out of School Clubs: I consent to my child participating in the on & offsite activities of TOPP KIDS Out of School Clubs Program:

INFORMATION I/We warrant and represent that the following information is accurate

CHILD’S SURNAME CHILD’S FIRST NAME LOCATION / SCHOOL

CHILD WILL BE ATTENDING:

KINDI CLUBS BEFORE & AFTERSCHOOL CLUBS DROP IN CARE

FULL DAY (Evergreen, St.Philips F.A., Maple Ridge, McKenzie Lake,

North Haven & Holy Child Elementary Schools Only.

FULL TIME (Before & After Care)

PART TIME (Before OR After Care)

PER DAY

$880 $525 $445 PAY PER USE

○ ○ ○ RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT I release TOPP KIDS Out of School Clubs and staff from any liability that may arise out of a TOPP KIDS Out of School Clubs activity or

outing. While every effort will be made to ensure my child’s safety, I will not hold TOPP KIDS Out of School Clubs liable for any

accident or other event that may occur. My permission and waiver of liability applies to the following: (please check each circle to note that item is understood)

⃝ Events that take place in and around TOPP KIDS Out of School Clubs.

⃝ Outings in and around Calgary that are part of the program. Neighbourhood walks, trips to parks, skating or other recreation. These

trips may also include changes in plans (i.e., due to weather) that parents may not be advised ahead of time due to the circumstances.

⃝ I acknowledge that the owner(s) of TOPP KIDS Out of School Clubs does not warrant any school or personal equipment or the negligent

use of any school or personal equipment.

ACKNOWLEDGEMENT OF RISK (please check each circle to note that item is understood)

I am aware that participating in the TOPP KIDS Out of School Clubs program has many inherent risks including but not limited

to: ⃝ theft, vandalism or loss of personal property;

⃝ depending on the particular activity, participants must understand certain risks, dangers, and injuries due to inclement weather, slipping,

falling, poor skill level or conditioning, strenuous physical activity or exertion, striking or being struck by objects or persons, exposure

to heat, cold or humidity, carelessness, horseplay, unsportsmanlike conduct, premises defects, inadequate or defective equipment, and

other circumstances inherent to outdoor and indoor recreational activities/programs exist.

PLEASE READ THE SECTION BELOW AND CHECK ALL CIRCLES TO CONFIRM YOU HAVE READ AND

UNDERSTAND EACH STATEMENT.

⃝ I have reviewed the TOPP KIDS Family Handbook information package and I am satisfied that I have been informed about this program’s

activities, policies and discipline policies.

⃝ I have explained the risks associated with this program to my child and she/he understands the risks. We freely and voluntarily assume

the risks inherent in the TOPP KIDS Program, and understand and acknowledge that the participant could suffer personal and potentially

serious injury.

⃝ TOPP KIDS Out of School Clubs may secure such medical advice and services as it, in its sole discretion, may deem necessary for my

child’s health and safety and I shall be financially responsible for such advice and services.

⃝ I understand that it is my child’s responsibility to abide by the rules and regulations imposed on the participants by TOPP KIDS

Program employees. I have explained to my child the need to follow the instructions given by instructional staff.

⃝ In the event that my child fails to abide by rules and regulations imposed by TOPP KIDS program employees, action may be taken that

either requires that s/he not participate in the activity, or that I will be contacted to have her/him picked up.

⃝ I understand that staff supervise my child while in attendance at TOPP KIDS Out of School Clubs, and in some cases they will also walk

children to community playgrounds, go on neighbourhood walks and take children on excursions within the community which are within

easy walking distance.

Supervision Policy: Once off site, TOPP KIDS Out of School Clubs will have minimum of 2 staff plus staff to meet ratio. Meeting or exceeding ratios at all off-site locations at all times.

⃝ I/We understand that TOPP KIDS Out of School Clubs will arrange field trips from time to time to swimming venues. I/We understand

that if my child has not completed Level 5 in a qualified swimming program TOPP KIDS Out of School Clubs recommends that my/our

child wears a life jacket at all times while swimming. It is my/our responsibility to ensure that my child brings a life jacket to swimming

venues should he/she be required to wear one. I/We understand that the program may decide that my/our child is not a strong enough

swimmer, and require my/our child to wear a lifejacket. I/We being the parent(s) and/or guardian(s) of ____________________ have

determined that my/our child (please check one):

⃝ May swim without a life jacket ⃝ Must wear a life jacket

⃝ I agree to HOLD HARMLESS AND INDEMNIFY the owner of TOPP KIDS Out of School Clubs from any and all liability for any damage to

the property of, or personal injury to, any third party resulting from my child’s participation in TOPP KIDS Out of School Clubs program

activities.

⃝ I acknowledge that as a result of the risks inherent in participating in TOPP KIDS Out of School Clubs, that my child may suffer

damages, including property damage and damages arising from personal injury or death. Despite these risks, nevertheless, I freely

accept and voluntarily assume all such risks, dangers and hazards and the possibility of personal injury, death, property damage or loss,

and all damages resulting therefrom.

EVALUATION PERIOD ⃝ The first month of enrollment in a TOPP KIDS program is an evaluation period. During this time program staff observe how a child is

integrating into the program. They monitor the child’s behavior, compare observations, and communicate any concerns or difficulties

observed with parents / guardians. Program Coordinators will make a recommendation to parents / guardians at the end of the

evaluation period as to whether the program is suitable. Program Coordinators will recommend that the child continue with TOPP KIDS,

if a Support Aide is needed (mandatory if requested by the Program Coordinator) or terminate care and suggest alternative / supportive

program options within the community.

STUDENT PHOTO/PROGRAM MATERIALSPhotographs and video footage taken of your child while at TOPP KIDS Out of School Clubs by an employee or representative of the

TOPP KIDS Out of School Clubs will become the property of TOPP KIDS Out of School Clubs.

I hereby consent to photos and/or video being taken of my child while they participate in TOPP KIDS Out of School Clubs program

activities.

⃝ Media, images or reproductions of original art and writing involving my child may be used in newsletters, www.TOPP

KIDS.com, social media, childcare sector workshops, or by community media outlets.

OR

⃝ Media, images or reproductions of original art and writing involving my child may be used onsite only and under no

circumstances may be used, released or posted for any public viewing outside of TOPP KIDS Out of School Clubs.

At no time will a child’s name be released. If you or your family wish otherwise, please inform one of the administration staff on the first

day of the program.

SUNSCREEN/ INSECT REPELLANT APPLICATION⃝ I hereby authorize TOPP KIDS Out of School Clubs staff to apply sunscreen (provided by parents) on my child in spring and summer as

needed.

⃝ I hereby authorize TOPP KIDS Out of School Clubs staff to apply insect repellent (provided by parents) on my child in spring and

summer as needed.

NON–PAYMENT OF FEES

⃝ All payments at TOPP KIDS are due on the 1st or the 15th of the month (whichever date was agreed upon at time of

registration). Any payments made after the 5 day grace period will be considered as a late payment and charged a $30.00

Late Fee (due the day payment is made).

⃝ Fees not paid by the 5th grace period day of the month are subject to having the families enrolment suspended until all fees

are paid in full with the addition of the $30 late fee charge.

⃝ Any fees in arrears for more than 30 days will result in a termination of enrolment in the program until the balance left owing

is cleared.

⃝ A $30.00 service charge will be charged on all NSF Cheques.

I HAVE READ AND UNDERSTOOD THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM ACCEPTING TOPP KIDS POLICIES AND PROCEEDURES IN THIS DOCUMENT AND THE TOPP KIDS FAMILY HANDBOOK AS WELL AS FINANCIAL RESPONSIBILITY FOR ANY SUBSITY OR MEDICAL ASSISTANCE TOPP

KIDS OUT OF SCHOOL CLUBS MAY DEEM NECESSARY FOR MY CHILD’S HEALTH AND SAFETY AND ALSO FOR ANY DAMAGE TO THIRD PERSONS OR THEIR PROPERTY THAT MY CHILD MAY CAUSE. I UNDERSTAND THAT TOPP KIDS OUT OF SCHOOL CLUBS POLICIES AND PROCEDURES CAN CHANGE WITHOUT FORMAL NOTICE

AS THE BRAND GROWS AND IT IS MY RESPONCIBILITY TO STAY INFORMED ON THESE CHANGES.

GUARDIAN INFORMATION I/We warrant and represent that the following information is accurate

SURNAME FIRST NAME DATE

SIGNATURE

FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT: Your personal information is protected by Alberta’s Freedom of Information and Protection of Privacy Act and can be reviewed on

request. We treat your personal information with respect and care and use it to serve you better. If you have questions about the

collection and use of this information, please contact us at (403)710- 8384 or ctopp@toppkids.com.

PARENT ACCREDITATION CONSENT FORM

Accreditation is a self-assessment process for early learning and care programs in Alberta. This process uses a tool, called a self-study

guide, which measures the quality of the care provided against a set of standards and criteria. This self-assessment process involves

parents, staff and owner/operators to recognize the level of quality in their program and to continuously improve and promote quality

care.

The accreditation process supports child care programs in their efforts to improve the quality of their services and provides parents with

information to enable them to choose quality care. By going through this rigorous accreditation process programs are committing to

raising the standard of care children receive in Alberta.

PARENT ACCREDITATION CONSENT FORM

PLEASE KEEP THESE FORMS ON FILE AND HAVE THEM AVAILABLE TO THE VALIDATORS WHEN THEY CONDUCT THE SITE VISIT

PLEASE CHECK ()

I consent to participate in the accreditation process site visit.

PLEASE CHECK ()

I give my permission to allow the accreditation Validators to look in my child/ren’s file to verify required information is present.

NAME OF CHILD (please print) NAME OF CHILD (please print)

PLEASE CHECK ()

I consent to being interviewed by a Validator if requested.

I consent for my child(ren) to be interviewed by a Validator if requested. (children ages 8-12 only)

I UNDERSTAND THAT THE PURPOSE OF THE ACCREDITATION PROCESS IS TO ENSURE A HIGH STANDARD OF CARE IN THE

PROGRAM. THE VALIDATORS WILL BE CHECKING TO SEE THAT ADMINISTRATIVE FILES ARE COMPLETE AND UP-TO-DATE. THE

INFORMATION FROM THE FILE REVIEW AND THE INTERVIEW WILL BE USED ONLY FOR THE PURPOSE OF ACCREDITATION.

NAME OF PARENT/GUARDIAN (please print) SIGNATURE OF PARENT/GUARDIAN DATE (dd/mm/yy)

Alberta Family And Social Services Day Care Subsidy

The Alberta Family And Social Services Day Care Subsidy is available to eligible lower- to middle-income families who need assistance to help cover

the fees for child care. Forms for the subsidy are available at http://www.child.gov.ab.ca.

HOW TO APPLY

You can now apply online using a computer, tablet, or mobile phone through the child care subsidy application.

Child Care Subsidy Application

Please read the eligibility requirements and make sure you understand what happens after you apply.

As part of the assessment process, they may contact you if they need additional information or documents.

If you need help or have questions about using the new child care subsidy online application, call the Alberta Supports Contact Centre at 1-877-644-

9992. If you experience any technical issues, have any feedback on the new application, or have any questions about an application you have

submitted, please email cs.subsidyappfeedback@gov.ab.ca.

After you apply online, you will need to submit the CRA Consent Applicant Declaration And Acknowledgement Form (PDF, 121 KB)

TO READ MORE, VISIT: HTTPS://WWW.ALBERTA.CA/CHILD-CARE-SUBSIDY.ASPX

Pre-Authorized Payment Plan Payor’s Authorization for PRE-AUTHORIZED DEBITS (PAD) for (1533948 Alberta Corp.) a.k.a. TOPP KIDS Out Of School Clubs

I/we authorize TOPP KIDS Out Of School Clubs and its affiliates and agents 1533948 Alberta Corp.) and the financial institution designated (or any other financial institution I/We may authorize at any time)

to begin regular recurring and/or one time deductions for payment of all charges arising under my/our TOPP KIDS account(s). Regular payments for the full amount of the TOPP KIDS bill will be debited to

my/our specified account on the 1st day of each program session. TOPP KIDS registrations will be debited to my/our account in full upon reception of TOPP KIDS. This authority is to remain in effect until

signed written notice has been received by TOPP KIDS. Please Note a 2% merchant fee will apply for credit card transactions and $0.15 processing fee for each PAD payment made through ATB Financial.

I may revoke my authorization at any time, subject to providing one month written notice, based on the last day of the month. To obtain a sample cancellation form. Or for more information on my right to

cancel a PAD Agreement, I may contact my financial institution or visit www.cdnpay.ca.

I/we have certain recourse rights if any debit does not comply with this agreement. For example. I/we have the right to receive reimbursement for any PAD that is not authorized or is not consistent with this

PAD Agreement. To obtain a form for a Reimbursement Claim. or for more information on my/our recourse rights, I/we may contact my/our financial institution or visit www.canpay.ca

Transaction Type Start Date New Set Up Cancelation Change Of Information

_____________________

Information 1) Payor’s (Parent/Guardian) Name and Address - please print

I/We warrant and represent that the following information is accurateSurname First name Mr. Mrs. Ms. Miss

Address

City Postal Code Telephone #

Email Address

Child’s Surname Child’s First Name Location / School

Choose A Payment Type

Pre Authorized Debit Credit Card Authorization Please attach a voided cheque or fill out below Please attach a voided cheque or fill out below

Type of Account: Business Personal Type of Account: Visa MC

Name of Payor’s Financial Institution (the Processing Institution)

Institution Number Transit Number Account Number

City Postal Code Address

Name On Credit Card

Credit Card Number

Expiration Date CVV/CVC (3 Digits)

Billing Address

Street Address City / Town

Province Postal Code Phone Number

Authorization

Authorization Signature

Date

1) Payee’s Name and Address

1533948 Alberta Corp. – Operating as of TOPP KIDS Out Of School Clubs

5918 3rd Street SW, Calgary Alberta

T2H 0H8

2) I/We acknowledge that the Authorization is provided for the benefit of the 1533948 Alberta Corp.. and the Processing Institution.

3) I/We hereby authorize the 1533948 Alberta Corp. to issue Pre-Authorized Debits (as defined in Rule H4 of the Rules of the Canadian Payments Association) (the “PAD”) drawn on the Account, for the

following purpose: TOPP KIDS Fees

4) I/We warrant and guarantee that all persons whose signatures are required to authorize withdrawals from the Account have signed the Authorization below.

5) I/We may revoke the Authorization at any time upon providing written notice to the 1533948 Alberta Corp. at least 30 days prior to the next due date of the PAD. To obtain a sample cancellation

form, or for more information on my right to cancel a PAD Agreement, I may contact my financial institution.

6) I/We have certain recourse rights if any debit does not comply with this agreement. For example, I have the right to receive reimbursement for any debit that is not authorized or is not consistent

with this PAD Agreement. To obtain more information on my recourse rights, I may contact my financial institution.

7) Revocation of the Authorization does terminate any contract for goods or services that exists between me/us and the Payee. The Authorization applies only to the method of payment and does not

otherwise have any bearing on the contract for goods or services exchanged.

8) I/We understand that all items returned unpaid, either as Non-Sufficient Fund or Uncollected Funds, will be subject to a $30.00 returned item fee to be debited from my/our account on re-

presentation of the item.

9) All Stop Payment orders and items returned unpaid as Account Closed made without the revocation of Authorization, as required under Section 6, will be subject to the immediate repayment of the

tuition fee and a $30.00 returned item fee through alternate means.

10) Payor consents for 1533948 Alberta Corp. to collect, use, retain and disclose Payor’s personal information for the purpose of collecting accounts remaining unpaid for more than 30 days.

11) I/We agree that the information contained in the Authorization may be disclosed to the Processing Institution as required to complete any PAD transaction.

12) The first PAD will occur on the following deposit date (1st or 15th ) of the month care begins.

13) I/We understand and accept the terms of participating in this PAD plan:

Registration Type:

KINDI CLUBS BEFORE & AFTERSCHOOL CLUBS DROP IN CARE

FULL DAY FULL TIME (Before & After Care)

PART TIME (Before OR After Care)

PER DAY

$880 $525 $445 PAY PER USE

○ ○ ○ Alberta Family and Social Services Day Care Subsidy – Complete this section only if you currently have subsidy in place. The Alberta Family and Social Services Day Care Subsidy is available to parents who need assistance to help cover the fees for child care. Forms for the subsidy are available at www.child.gov.ab.ca . Once

a subsidy has been granted parents will receive a subsidy approval letter, a copy of which should be brought to the TOPP KIDS Coordinator within 2 weeks of registering. All families with subsidies must

are responsible for the difference between the currently approved subsidy allowance and the cost of their fee for each month registered. Any remaining fees will be charged on the 15th of the following

month after subsidy amounts are forwarded back to the program. Parents are responsible for paying any remaining fees by the 15th of that month. Deposit Policy still applies. It is the parent's responsibility

to track and ensure their child reaches the minimum number of hours per month needed for a full subsidy payment as every family may be different.

Family ID Number Child ID Number Child’s DOB (Date Of Birth) Amount Approved for ($) # Of Minimum Hours

Start Date Expiry Date

Payor’s Consent - Must be completed.

Client Signature Name (Please Print) Date

Joint Account Holder Signature Name (Please Print) Date

FOR 1533948 ALBERTA CORP. USE ONLY

Date VOID Cheque Received CC Authorization Received

Payments Scheduled For Start Date Registration Fee Charged

⎕ 1st ⎕ 15th

Location Registration Type (FT / PT / Drop In)

(Evergreen, St.Philips F.A., Maple Ridge, McKenzie Lake,

North Haven & Holy Child Elementary Schools Only.

PARENT SURVEY

I heard about the TOPP KIDS Before & After School program/ Summer Camps through:

⃝ Participant of TOPP KIDS

⃝ Advertisements in schools

⃝ TOPP KIDS Website

(www.toppkids.com)

⃝ Friend/Family Member/Co-worker

⃝ Calgary Child Care Services Guide

⃝ CareFind

⃝ Google

⃝ Other (please specify)

______________________________

______________________________

I chose TOPP KIDS because (check all that apply):

⃝ Location

⃝ A friend of my child is attending

⃝ Affordability

⃝ Child/staff ratio

⃝ Daily programming

⃝ My child wanted to attend

⃝ Spring & Summer programs

⃝ Other (please specify)

______________________________

_____________________________

Would you be willing to volunteer at TOPP KIDS for:

⃝ Accreditation/ Parent Board

⃝ Open houses

⃝ Parties and events

⃝ Cultural/ job presentations

⃝ Field trips

⃝ Joining in on the fun!

www.TOPP KIDS.com We thank you for your valuable feedback!!!

FOR ADMINISTRATION PURPOSES ONLY

⃝ Consent Package signed.

⃝ Timesavr file completed

⃝ All Post-dated cheque(s) or PAD received.

⃝ Scheduled spot reserved.

⃝ Emergency sheet (Child Profile) printed and

posted in emergency binder.

⃝ Medication sheet copied, dated and posted

in emergency binder

Checked By: __________________________

Start Date: _______/__________/_________

End Date: _______/__________/_________

Cheque #’s: ______, _______, _______,

______, _______, _______,______,

_______, _______,______,______.