Registration Form

Name of Child *
Name of Child
Child's Home Address *
Child's Home Address
Child's Date of Birth *
Child's Date of Birth
Children must be three years of age by December 31 of their enrolment year
Doctor's Phone Number *
Doctor's Phone Number
Immunizations Complete *
Mother's/Guardian's Name *
Mother's/Guardian's Name
Mother's/Guardian's Cell Phone *
Mother's/Guardian's Cell Phone
Mother's/Guardian's Address *
Mother's/Guardian's Address
Mother's/Guardian's Work Phone *
Mother's/Guardian's Work Phone
Father's/Guardian's Name
Father's/Guardian's Name
Father's/Guardian's Cell Phone
Father's/Guardian's Cell Phone
Father's/Guardian's Address
Father's/Guardian's Address
Father's/Guardian's Work Phone
Father's/Guardian's Work Phone
Alternate Emergency Contact Name *
Alternate Emergency Contact Name
Alternate Emergency Contact Phone *
Alternate Emergency Contact Phone
Emergency Address *
Emergency Address
Please list any allergies your child might have, including medical requirements/treatments
Please list any fears or sensitivities your child might have
Please share any other important information you would like us to know
Program *
Please select the program to which you would like to register your child

Please note that a $50 non-refundable registration fee will be required to confirm your registration. We'll be in touch to make arrangements for this when your form is submitted.