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Child care Registration Form
2019-2020 School Year
Please choose the Program you are registering for? *
Child Legal Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Telephone number *
Your answer
Gender *
Mailing address ( street, city, province, postal code) *
Your answer
last school attended, location ( if applicable)
Your answer
Medical Information ( allergies, medical conditions, etc) if school staff will be required to administer medication, please request the appropriate form from the school office)
Your answer
Is your child 's Immunization up to date ? *
Citizenship- Is the student Canadian Citizen *
Citizenship, if not Canadian
Name of official citizenship document ( copy to be provided to the office) *
Your answer
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