Waiting List Application Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Please select which session you are applying for: Preferred EMERGENCYCONTACTName3 MOTHERBusinessPhone Toddler program (12 months to 2 1/2years old):5 Full days (7:30am to 6:00pm)Preschool program (2 1/2 – 6 years old):5 Full days (7:30am to 6:00pm)Preferred Date of EnrolmentHealth Information Child PediatriciansNameChildname *PediatriciansAddressChildsaddressPediatriciansphone CHILDBirthdateAllergiesCHILDLanguagespokenathomeRestrictionsHas your child had any previous school experience? YesNoYesNoWhatcommunicablediseasehasyourchildbeenexposedtoCHILDIfyeswhere Please provide name(s) address, Tel. No. of person(s) who may collect your child at a short notice CHILDSchoolDurationPersonswhomaycollectyourchildatashortnotice1Parent Personswhomaycollectyourchildatashortnotice2MothernamePersonswhomaycollectyourchildatashortnotice3MotheraddressIn case of emergency, please contact MotherpostalcodeEMERGENCYCONTACTName1MotherHomePhonesEMERGENCYCONTACTPhone1MOTHERCellularPhoneEMERGENCYCONTACTRelationship1MOTHEROccupationEMERGENCYCONTACTAddress1MOTHERBusinessPhoneEMERGENCYCONTACTName2MOTHERBusinessAddressEMERGENCYCONTACTPhone2Motheremailaddress *EMERGENCYCONTACTRelationship2Parent EMERGENCYCONTACTAddress2FATHERNameEMERGENCYCONTACTName3FATHERHomeAddressEMERGENCYCONTACTPhone3FATHERPostalCodeEMERGENCYCONTACTRelationship3FATHERCellularPhoneEMERGENCYCONTACTAddress3FATHERHomePhone FATHEROccupation FATHERBusinessPhoneFATHERBusinessAddressFatheremailaddress1 *Submit