Child Care Request If you are inquiring about a full-time, part-time or after-school childcare space in any of our centres we ask that you complete the availability request form below. Fields marked with (*) are required. 1Child Info2Parent Info3Childcare Options4Notes Child's InformationName* First Last Date of Birth (DD/MM/YYYY)*DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear2030202920282027202620252024202320222021202020192018201720162015201420132012Gender* Male Female Address* Street Address City State / Province / Region ZIP / Postal Code Parent/Guardian InformationParent OneName* First Last Email* Cell*Home Phone*Bus Phone*Parent TwoName First Last Email CellHome PhoneBus Phone Childcare OptionsDesired Start Date (DD/MM/YYYY)*DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear2030202920282027202620252024202320222021202020192018201720162015201420132012Location*Select Location:North Toronto - 2005 Sheppard AvenueMarkham - 17 Cornell Meadows AvenueLeslieville Toronto - 1055 Gerrard Street EastGoodwood/Uxbridge - 292 Hwy 47, GoodwoodProgram*Select Program:Infant (0 to 18 months)Toddler (18 to 30 months)Preschool (2.5 to 5 years)School-age (5 to 12 years)Requested Days* Monday Tuesday Wednesday Thursday Friday Type of Care* Full Day Half Day Before & After School Care How did you hear about us?* Family or Friend Signage Magazine or Newspaper Ad Search Engine Online Directory or Website Social Media (Facebook, Instagram etc...) Other Name of Directory or Website:*Please provide details:* Comments or Additional InfoConsent* I agree to the privacy policy.We never share your information with third parties. Please read our privacy policy for more information about we store and use your personal information.