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Map to 450 OBrien Rd
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Child's Paradise Day Care Centre
Child Registration Waiting List Form
Child Information
Child's First Name:
Child's Last Name:
Date of Birth:
Month:
Day:
Year:
Select Program
Please Select:
Toddlers
Nursery School
Preschoolers
Kindergartens
School-Agers
Parent Information
Parent Salutation:
Mr.
Mrs.
Miss
Ms.
Parent's First Name:
Parent's Last Name:
Address:
City/Town:
Province/State:
Postal/Zip Code:
Country:
Phone Number (please include area code):
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E-mail Address:
How Did You Find Out Child's Paradise/Reffered By?
Please Select:
Google Search
Yahoo Search
MSN Search
Other Search Engine
Brochure
Web Ad or Listing
Newspaper
Print-Other
Friend or Co-Worker
TV or Radio
Start Date of Care (When Needed):
Month:
Day:
Year:
Days Requested:
Times Requested:
Other important Information:
Image Verification Code:
Please Enter the Verification Code that you see in box to submit.
Thank you for considering Child's Paradise Day Care Centre.
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