Rainy River Child Care Application

Please note that completing this form does not guarantee your child a spot in a childcare centre.

Please complete a form for each child.

Please indicate which child care centre you are applying for:

River’s Edge Atelier (Rainy River, co-located within the new Rainy River K-12 School)

CHILD CARE REQUIREMENTS (check all that apply)

I would like my child to start:

when River’s Edge Atelier opens
on a different date

Please confirm drop off and pick up times based on your family’s need for care.

Monday Drop off Time

Tuesday Drop off Time

Wednesday Drop off Time

Thursday Drop off Time

Friday Drop off Time

Monday Pick up Time

Tuesday Pick up Time

Wednesday Pick up Time

Thursday Pick up Time

Friday Pick up Time

CHILD INFORMATION (PLEASE COMPLETE A SEPARATE FORM FOR EACH CHILD YOU WISH TO ADD TO THE WAITLIST)

Full Legal Name:

Date of Birth:

To ensure your child has the best possible experience in our program, we want to make sure that the necessary supports are in place before they start. If there are any specific needs or considerations that would help us better understand how to support your child, please feel free to share.

If you are comfortable, please share the names of any services or agencies involved with your child (e.g. Developmental Services, Northwords Speech & Language, Occupational Therapist, etc.). This will help us understand how to best support your child.

To help ensure your child’s health and safety, please let us know if your child has any allergies or needs an epi-pen.

Yes
No
Epi-pen required

CHILD CARE PRIORITY

Do you currently have a child(ren) enrolled in a licensed full-day child care centre in Rainy River?

Yes
No

& any our

Do you currently have a child(ren) on the wait list with a licensed full-day child care centre in Rainy River?

Yes
No

CHILD CARE FEE SUBSIDY

Fee Subsidy can help you with your child care fees. It provides financial support to those who qualify to assist with the costs of licensed child care. All families are welcome to apply. For more information or to apply, please visit our website at www.rrdssab.ca or call us at (807) 274-5349 ext. 231.

PARENT/GUARDIAN INFORMATION:

First and last name:

Relationship to child:

Primary phone number:

Alternate phone number:

Home Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Mailing Address (if different):

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Email

Additional Information:

By submitting this application, I consent to the collection of this information for the purpose of supporting my child’s participation in the child care program. I understand that I can withdraw or update my consent at any time by contacting the District of Rainy River Services Board.

If you have questions regarding the child care wait list application, please call (807) 274-5349 ext. 226.

To access our child care waitlist policy, please visit our website at www.rrdssab.ca