A Place for Parents and their Children

Registration Form

Vaughan-King-Aurora Ontario Early Years Centre - Woodbridge Location

Tell us about the parents/caregivers in your family:

Parent/caregiver One:
First Name
Last Name
Date of Birth
Sex Male
Female
Relation to the child:

Parent/caregiver Two:
First Name
Last Name
Date of Birth
Sex Male
Female
Relation to Child

Parent/caregiver Three:
First Name
Last Name
Date of Birth
Sex Male
Female
Relation to Child

Tell us about the young children in your family/in your care:

Child One:
First Name
Last Name
Date of Birth
Sex Male
Female
Own/Other Child

Child Two:
First Name
Last Name
Date of Birth
Sex Male
Female
Own/Other Child

Child Three:
First Name
Last Name
Date of Birth
Sex Male
Female
Own/Other Child
Languages:
What is/are the primary language(s) spoken in your household?
(Please list all that apply.)

Tell us how we can contact you:
Address:
City
Province:
Postal Code
Home Phone Number
Cell Phone
Other Phone
Email

Emergency Contact:
First Name
Last Name
Relation
Phone Number
Other Phone Number

 

Don’t forget to inform us if your information changes in the future!
This form is confidential and will not be shared with any other organization.

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