Waiting List Application Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. EMERGENCYCONTACTName3 MOTHERCellularPhone EMERGENCYCONTACTAddress2 Please select which session you are applying for: Toddler program (12 months to 2 1/2years old):5 Full days (8:00am to 5:30pm)Preschool program (2 1/2 – 6 years old):5 Full days (8:00am to 5:30pm)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 CHILDSchoolDurationPersonswhomaycollectyourchildatashortnotice1Mother Personswhomaycollectyourchildatashortnotice2MothernamePersonswhomaycollectyourchildatashortnotice3MotheraddressIn case of emergency, please contact MOTHERPostal_codeEMERGENCYCONTACTName1MotherHomePhonesEMERGENCYCONTACTPhone1MOTHERCellularPhoneEMERGENCYCONTACTRelationship1MOTHEROccupationEMERGENCYCONTACTAddress1MOTHERBusinessPhoneEMERGENCYCONTACTName2MOTHERBusinessAddressEMERGENCYCONTACTPhone2Motheremailaddress *EMERGENCYCONTACTRelationship2Father EMERGENCYCONTACTAddress2FATHERNameEMERGENCYCONTACTName3FATHERHomeAddressEMERGENCYCONTACTPhone3FATHERPostalCodeEMERGENCYCONTACTRelationship3FATHERCellularPhoneEMERGENCYCONTACTAddress3FATHERHomePhone FATHEROccupation FATHERBusinessPhoneFATHERBusinessAddressFatheremailaddress1 *Submit