Guthrie Mighty Learners - Early Learning & School Age Program
Pre-Registration for School Year 2023-2024

Kindly note:
This is not the enrollment form, it is a pre-registration form.
As spaces are limited, all pre-registrations are first-come first-serve. We will contact you directly to secure your space. If you have any questions, please direct them to namaomightylearners@gmail.com
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Program
Kindly fill out 1 form per child
 *
If school age, what grade is your child in? *
Type of Care required
Full-time, Part-time, or kindly indicate days and hours of care
 *
Child's full legal name *
Child's Date of birth (mm/dd/yyyy) *
Are your child's immunizations up to date?
This question is a licensing requirement
 *
Does your child have any allergies? *
Does your child have any emergency or on-going medications? *
Does your child have any medication conditions that we should be aware of? *
Does your child require inclusion? *
Parent Full Legal Name *
Full physical address (Street, City, Province, Postal Code)
P.O Box not accepted
 *
Home or Cellphone Number *
E-mail Address *
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