PARENT NAME (FIRST, LAST) *

CHILD’S NAME (FIRST, LAST) *

CHILD’S DATE OF BIRTH, or estimated birth date, if expecting *

EMAIL *

TELEPHONE (DAYTIME)*

City *

Postal Code *

PROGRAM OF INTEREST *
Select a ProgramInfant - available in select locationsPre-casaCASA - up to 6 yrsSchool AgeSummer Kids CampOther

SCHOOL LOCATION OF INTEREST *
Select LocationPickering NOT ACCEPTING APPLICATIONS, CWELCC approvedVaughan, CWELCC approvedUptown - NO INFANT PROGRAM, CWELCC approvedMiltonKleinburgKitchenerBurlington - CWELCC approved, COMING SOONCampbell Heights - COMING SOONWhitby - COMING SOONNew Seaton - COMING SOONBrooklin - COMING SOON

HOW DID YOU HEAR ABOUT US? *
Select LocationDirect Mail/FlyerRadioCommunity Paper/OnlineInternet searchAdvertisement – printAdvertisement – digitalSignReferralSocial mediaOther

IDEAL START DATE *