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Little Lights Early Learning Centre Waitlist
Please note:
Priority is given to those requiring full-time care.
Child #1 Information
First Name
*
Middle Name
Last Name
*
Birthdate
*
Age
*
Gender
Select one
Female
Male
Child #2 Information
First Name
Middle Name
Last Name
Birthdate
Age
Gender
Select one
Female
Male
Please Answer The Following
Please note:
Priority is given to those requiring full-time care.
Please Select Start Date
*
Do You Require Full Day or Part Day Care?
*
Select One
Full Day
Part Day (For 3 & 4 Year olds)
Please Select Which Days You Will Require Childcare
Monday
Tuesday
Wednesday
Thursday
Friday
Mother's Information
Mother's First Name
*
Mother's Last Name
*
Mother's Phone Number
*
Mother's Email Address
*
Father's Information
Father's First Name
*
Father's Last Name
*
Fathers's Phone Number
*
Father's Email Address
*
Home Address
Street Address
*
City
*
Postal Code
*
Mailing Address
(if different from above)
City
Postal Code
Comments
Please add any other information you would like us to know
Submit