Program Registration Form V3 Adult Adult Name * Name First First Last Last Name * Name First First Last Last Email * Phone * Have you submitted an Annual Registration Form during the past 12 months? * Yes No Children Number of children attending programs * 0 1 2 3 4 Child Child's Name * Child's Name First First Last Last Date of birth * Child Child's Name * Child's Name First First Last Last Date of birth * Child Child's Name * Child's Name First First Last Last Date of birth * Child Name * Name First First Last Last Date of birth * Program Request Location * Antrim Site Apsley Site Bridlewood/Harper Park Facebook Post Isabel Morris Park Jackson Park Lakefield Site Mill Pond Forest Trails Newhall Neighbourhood Park Norwood Town Hall Online-Virtual Programs Otonabee Valley Site St. John CES Program Name * Breastfeeding & Well Baby Clinic Breastfeeding Basics Chat and Stroll Infant Family Play to Learn Family Play to Learn Feeding Your Baby Footsteps to Parenting Infant Massage Kids in the Kitchen Let's Talk About Sleep, Baby! Library Me & My Dad Parent Child Mother Goose Roots of Discovery Bridlewood/Harper Park Roots of Discovery Jackson Park Sensory Artists Song and Signs South End Sing Along Toddler and Preschool Fun Triple P One-On-One Triple P Prepping Your Child Triple P Seminar Series Triple P Toddlers and Tantrums New Option Program Name Date * Add another program Comments / Questions If you are human, leave this field blank. Submit
