Nurturing Minds Daycare Registration Form
Please fill out the required information below to register your child to Nurturing Minds Daycare & OSC. Please note that we will contact you to upon the submission of this form.
Child's First Name
Child's Last Name
Address
Email
Phone Number
Gender
Select below
Male
Female
Date of Birth
Alberta Health Card
Allergy/Medical Condition
Is your child's immunization is up to date?
Yes
No
Family Doctor
Family Doctor's Phone Number
Mother's Full Name
Mother's Address
Mother's Phone Number
Mother's Employer's name
Mother's Employer Phone Number
Father's Name
Father's Address
Father's Phone Number
Father's Employer's Name
Father's Employer Phone Number
(1.) Emergency Contact Person's Name
(1.) Relationship to the child
(1.) Emergency Contact's Phone Number
(2.) Emergency Contact's Name
(2.) Relationship to the child
(2.) Emergency Contact's Phone Number
(3.) Emergency Contact's Name
(3) Relationship to the child
(3) Emergency Contact's Phone Number
Parent Signature
Clear
Register your Child Now!
Powered by