Child's Name
*
First Name
Last Name
Do you consent to having your child's photo taken and used on the program website?
Student lives with:
Custody
If other, please specify the custody and living arrangment
Personal Health Number
Name of Doctor
Doctor's Phone Number
(###)
###
####
Does your child take any medications regularly during the day?
Does your child have any allergies?
Does your child have any special diet?
Does your child have any pre-existing health conditions?
Does your child have any fears or anxieties?
What is the best way to comfort your child in a stressful situation?
Is there anything else we should know about your child's health and wellness?
EMERGENCY CONTACTS
Legal Guardian 1
First Name
Last Name
Home/Cell Phone
(###)
###
####
Work Phone
(###)
###
####
Best Number to Contact
Call or Text?
Address
Legal Guardian 2
First Name
Last Name
Home/Cell Phone
(###)
###
####
Work Phone
(###)
###
####
Best Number to Contact
Call or Text?
Address
Emergency Contact #1
Someone who is not a parent or guardian who can be contacted in an emergency.
First Name
Last Name
Relationship to Child
Phone
(###)
###
####
Best way to be in touch
Emergency Contact #2
First Name
Last Name
Relationship to Child
Phone
(###)
###
####
Best way to be in touch
Waiver of Liability
By typing your name below you acknowledge an electronic signature of the waiver. We will also provide waivers on the first day of the program, to be signed in person.
I understand that my child will be performing actions associated with outdoor play such as but not limited to: running, climbing, playing near and in the water, walking on rocks and forest trails.
I am familiar with the usual risks associated with such activities. I allow my child to participate in these activities, and accept the risk of an accident occurring. My child/ward has my permission to participate in all session and field trip activities. In the case of an emergency, I hereby request and authorize the teaching staff to provide First-Aid, and when necessary a physician, hospital or healthcare provider to provide prompt medical treatment, whether or not I may be contacted or informed.
By signing the Meadowstone Farm Nature Program Waiver, I certify that I am the Parent or Legal Guardian of the above-named child, who is under the age of 18 years and who wants to participate in the program.
I give my permission for my child to be treated with
Parent Jobs
Parent involvement is a key aspect of our program. Please select the areas where you would like to help.
The Meadowstone Farm Nature Program is governed by parents and a board of directors. We encourage parents to join the board and to help run our school!
Please select any of the following roles you might like to participate in.
Community Values
What types of values or activities are important to you as a member of our parent community? For example: sharing meals together, field trips, community festivals, rituals, singing, dancing...!
Tell me about your child!
How would you describe the nature and personality of your child? What particular qualities do they posess?
What are your child's particular interests? What are their favourite things to do or learn about?
What are your child's particular strengths?
What are your child's particular challenges? Any difficulties or areas for development.
Tell us about your values around learning
What matters most to you regarding your child’s education and development? What are the values and skills you most wish for them to have in life?
Why did you choose this program for your child and family? What do you value most about a blended home-learning program?
In what area / in what ways, are you needing the most support as a home-schooling parent?
What are some of the values and activities you wish to see integrated into the classroom program?