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Please Note: No refunds for online purchases.

* Indicates required information

First child
 

Child's name: *

Month Day Year

Day of Birth: *

Health card number:

Gender: *  Female   Male

Does your child have any medical conditions the staff should be aware of (i.e. allergies)?

Indicate any special medical attention your child may require:

For possible future advertising we need consent from parent to include photographs and video of children *

Yes   No

 

Select program date(s): *

January 24, 2020 (full day)

April 3, 2020 (full day)

April 13, 2020 (Easter Monday, full day)

May 29, 2020 (full day)

June 26, 2020 (WRDSB only, full day)

January 27, 2020 (full day)


Emergency contact information
 

Contact name(s): *

Home phone: *

Work phone: