Register Your Child
Please fill out this form to register your child. * Denotes required items. FULL ADDRESSES INCLUDING POSTAL CODES ARE REQUIRED.

Program Selection

Our 2024/2025 School year starts on September 9, 2024 and ends on June 12, 2025.

Programs run from 9:00am to 11:30 am.

The toddler program is for children 18 months to 2.5 years of age and operates Monday to Thursday.

The pre-school program is for children 2.5 years to 5 years of age and operates Monday to Friday

If your program of choice is not available you may be placed on a waiting list.

Toddler- 2 days: M/W or T/Th or 4 days: M/T/W/Th.

Preschool - 2 days: M/W or T/Th, 3 days: M/W/F or T/TH/F, 4 days: M/T/W/TH or 5 days - M/T/W/TH/F

Child's Information

Full Address Including Postal Code

Parent Information

Parent 1's Information

Parent 2's Information

Physician's Information

Provide information in case of emergency

Emergency Contacts

The emergency contact cannot be a parent or primary guardian that is already listed. The teachers will always call the parents/primary guardians first, and in the event that they cannot be reached they will call the emergency contact.

Individuals Authorized to Pick up Child

If your child will be picked up by someone other than a parent, they must be authorized to do so.

Individuals NOT Authorized to Pick Up Child

List anyone NOT authorized to ever pick up your child.

Immunization Records

In order to attend day care in Halton Region, your child’s immunization records must be submitted to Halton Public Health ( and a copy must be provided to the child care centre for the child's physical file. If you decide not to vaccinate, a notarized letter of consent must be provided. More information will be provided upon request.

Child's Medical Information

The Child Care and Early Years Act, 2014 requires the following medical information on file. Please fill out below. If there are none, simply type N/A or None.
If yes, please include their reaction and treatment.
Please explain.
Please explain.
Please explain.
Please explain.
Please explain.
Please explain.
If Yes, please indicate which disease(s) and when.
If you child has a special medical condition (including but not limited to allergies), please indicate the condition, specific warning signs or symptoms, triggers (if applicable) and emergency measures to be taken. Additional documentation is required to anaphylactic allergies, asthma or medications required to be taken during care.

Other Information

Any information you want to add about you or your child? Do you celebrate any specific holidays or cultural events that we should be aware of?


We would like to share photos of the children on our private parent facebook group as documentation of their time in care. Photos will not be shared publicly.


You will receive a copy of this application by the email provided in Parent #1 field.