Waiting List
Fields marked with a * are required.
Date
*
-
Month
-
Day
Year
Date Picker Icon
Name
*
First Name
Last Name
Home Phone
*
-
Area Code
Phone Number
Cell Phone
-
Area Code
Phone Number
E-mail
*
Child's First and Last Name
First Name
Last Name
Child's Birth Date
*
-
Month
-
Day
Year
Date Picker Icon
Desired Start Date for Child Care
*
-
Month
-
Day
Year
Date Picker Icon
What Grade Will Your Child Be In When Care Is Needed? If Your Child Is Not Enrolled, Please Select N/A
*
N/A
JK/SK
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Is Your Child Under the Care of Any Professional Services?
Yes
No
Desired Program
*
Oakville Toddler (2 to 2.5 years)
Oakville Juniors (2.5 to 4 years)
Oakville Before/After Program (JK/SK)
Oakville Before/After Program (6 to 10 years)
Additional Comments
Where Did You Hear About Us?
Referral From Existing/Former Parent
Referral From Staff Member
Referral From Community Member
Facebook
Internet Search
Other
Submit
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