Preregistration — Holy Child After School Care Program

Please complete the pre-registration form below and a member of our staff will follow up.

Parent Name

First Name

Last Name

Email

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone (Main)

(###)

###

####

Phone (Alternate)

(###)

###

####

Child's Information

Child's Name

First Name

Last Name

Age

Grade

Start Date

MM

DD

YYYY

Contact

9844 110 St NW
Edmonton, AB T5K 1J2

Phone
(780) 920-5813