Step 1 of 4

REGISTRATION FORM

All sections must be filled out before your child may attend the day care. Please take the time to fill it out thoroughly and with as much detail as possible to enhance your child’s care.

Ideal Commencement Date(Required)

1. Identifying Information

No post office box numbers; physical addresses are necessary.

Child 1

Full Name(Required)

Date of Birth(Required)

Home Address(Required)

Home Phone(Required)

Gender(Required)

Male

Female

Date of Enrolment(Required)

Alberta Health Care #(Required)

Child 2

Full Name

Date of Birth

Home Address

Home Phone

Gender

Male

Female

Date of Enrolment

Alberta Health Care #

Parent/Guardian 1

Full Name(Required)

Relationship(Required)

Home Address(Required)

Mobile Phone(Required)

Email(Required)

Place of Employment(Required)

Employment Address(Required)

Employment Phone(Required)

Parent/Guardian 2

Full Name

Relationship

Home Address

Mobile Phone

Place of Employment

Employment Address

Employment Phone

Names and Ages of Siblings:

2. Attendance

Will your child attend full-time, part-time, drop-in, weekends, or respite?

***Please include days of the week, times per day and/or an advance schedule if days are not consistent

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REGISTRATION FORM

1. Identifying Information

Child 1

Child 2

Parent/Guardian 1

Parent/Guardian 2

Names and Ages of Siblings:

2. Attendance

3. Fees Policy

4. Emergency Contact Information - Essential Information

Emergency Contact 1

Emergency Contact 2

Authorized Person 1

Authorized Person 2

5. Medical Data

6. Family Information

7. General Information

Links

Contact

Mailing List

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