Parent Child Community Programming Registration Form "*" indicates required fields Child's Name* First Last Parent / Guardian Name* First Last Phone*Email* Early Learning Program (Preschool/Childcare) child is attending* Name of adult attending with your child* First Last Relationship of adult attending to your child* Preferred location and session time (please select one):*Please note sessions will be held monthly. Monday AM - Midnapore - 101-239 Midpark Way SE Monday PM - Midnapore - 101-239 Midpark Way SE Thursday PM – Cochrane 2208, 120 – 5th Avenue West Thursday AM – FCB Northeast – 129- 2640 52 Street NE Thursday PM – FCB Northeast – 129- 2640 52 Street NE Parent/Guardian Signature* Reset signature Signature locked. Reset to sign again Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920CAPTCHAIf you have any questions or concerns please contact Laura Petley Early Learning Coordinator – laura.petley@foothillscreative.org.
