Family Place's Program Registration Form
Please complete this form to register for our programs. If you wish to register for an additional program(s) simply submit another form or comment in the comment section.

If you are interested in registering for our New Beginnings Prenatal Classes, please also email: to obtain a registration package.

If you would like more information about our programs and services please call 436-1348, visit us at: or our Face Book group: or Facebook Page:

Completion of this form does not constitute successful registration. You will receive an email confirming your registration or placement on a waitlist. If you do not receive an email, please email us at:

During Covid, some of our staff work from home so please email us ( rather than leave a phone message.

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Email *
Untitled Title
Parents/ Guardians Alternate Email
Parents/ Guardians Name (Mother/ Father) *
Please include mothers/ guardians full name. Example, MacDonald, Mary
If Pregnant, your Due Date *
First name followed by Age
Prenatal Classes - Important
Please ALSO email to get a registration package.
Children's Names, Age & DOB *
First name followed by Age
Parents/ Guardians Phone Number(s) *
List contact information for both mother/ guardians here. For example, 436-1234 (h), 888-1234 (w), 954-1234 (C)
Parents/ Guardians Mailing Address *
Program(s) Registering For *
If you selected 'Parenting Program' above please specify which parenting program you are interested in (if applicable).
If you selected 'Playgroups' or 'Family Programs' or 'Healthy Living Programs' above please specify which program you are interested in  (if applicable).
If you selected 'Reggio Kids' above please specify which program you are interested in: A: Mon @ Tue, B: Wed, Thur & Fri or C: Mon, Tue, Wed, Thur & Fri. To qualify for tuition subsidy from the Province for the 5 afternoon Pre-K program, your child must be 4 years old by December 31 and must be registered in the 5 afternoon per week program.
Additional Information or Comments
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