Parent Interest in Child Care
Thank you for your interest in a Day Home with R&S Quality Dayhome Agency. 

Once this form is submitted, an educator will contact you if there is availability in their home. Availability is based on how many children the educator has in their home, what the ages of the children are, if your child's age fits in that ratio, and if they can accommodate your needs. We must follow the Family Day Home Standards Manual for Alberta.

Our agency policy allows children 10 months up to kindergarten. Space may be available for school-age children during the summer months only.

If you do not hear back from us, it unfortunately means that we do not currently have any homes available that meet your needs.
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Have you connected with a dayhome with R&S Agency yet? *
If yes, name of the Dayhome Educator (if known).
Parent's Contact Information. 
This may include parent, guardian, and/or authorized person (i.e. social worker, kinship).
First Parent
Main contact person
First Name *
Last Name *
Phone Number *
Email Address *
Street Address *
City/Town *
Postal Code *
Second Parent
First Name
Last Name
Phone Number
Email
First Child
First Name *
Last Name *
Birthdate *
MM
/
DD
/
YYYY
Gender *
Service Type *
Does your child require any additional attention or have any needs we should be aware of? *
Required
If you you answered Yes, please indicate what is required or needed to help us match those needs to an educator. *
Second Child
First Name
Last Name
Birthdate
MM
/
DD
/
YYYY
Gender
Clear selection
Service Type
Clear selection
Does your child require any additional attention or have any needs we should be aware of? *
Required
If you you answered Yes, please indicate what is required or needed to help us match those needs to an educator.
Do you have a third child needing care?
Clear selection
What time will you be dropping off your child/children? *
What time will you be picking up your child/children? *
Check the days of the week needed. *
Required
Expected Start Date *
MM
/
DD
/
YYYY
Expected End Date (if known)
MM
/
DD
/
YYYY
Name the neighbourhoods/communities you are looking for child care (within Calgary and Airdrie). Specify the community and Quadrant (NE,SE, NW, SW). *
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