2023 Annual EarlyON Registration Form
“Children are competent, capable of complex thinking, curious, and rich in potential. They grow up in families with diverse social, cultural, and linguistic perspectives. Every child should feel that he or she belongs, is a valuable contributor to his or her surroundings, and deserves the opportunity to succeed.”
 How Does Learning Happen? Ontario’s Pedagogy for the Early Years (2014)

EarlyON centres offer free drop-in programs for caregivers and children from birth to 6 years old. You can learn and play with your child, meet people or get advice.

Personal information on this form is collected under the authority of the Child Care and Early Years Act, S.O. 2014, c.71, and will be used to determine the planning, delivering, evaluating and monitoring the EarlyON Child and Family Centre programs and services. Questions about this collection should be directed to the North Hastings Children’s Services Executive Director, 20 Hastings Heritage Way, Bancroft, Ontario, K0L 1C0 (613) 332-0179.
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Parent/Caregiver Name: *
Date of Birth *
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Parent/Caregiver #2 (if attends) Name:
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Mailing Address: *
Email Address *
Phone Number: *
Name of Child:
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Name of Child:
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Name of Child:
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Name of Child:
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Optional Registration Information – In order to deliver quality and relevant programming please complete any or all in this voluntary section. Your information will be kept confidential. Myself and/or my family is connected to the following group; (Please check all that apply)
Please select factors in the programs that are relevant (select all that apply); *
Required
Policies: *
Agree
I agree that I am responsible for the supervision of my child(ren) while attending EarlyON Child and Family Centre Programs.
I release North Hastings Children’s Services from all responsibility in respect of any injuries which result from using toys and resource materials
I understand that should I have a concern regarding the quality, access or equity in any of the EarlyON Programs I can email the Executive Director, at janderson@nhcs.ca or call 613-332-0179, at any time. the Executive Director, at janderson@nhcs.ca or call 613-332-0179, at any time.
Photo Consent and Release: I grant permission to North Hastings Children’s Services (NHCS), to publish for internal and external purposes, articles and stories, photos, video and audio footage either of myself and of my children named in this registration. I understand that NHCS will use this material in publications, in marketing, communications and advertising material and on its internet properties, both now and in the future. The materials approved will remain the exclusive property of NHCS, and may be reproduced by NHCS, and anyone it has authorized, without compensation or payment to the individuals concerned or any other person. *
Is there anything you would like to share with us that we would need to know before attending an EarlyON  Program for example "Do you have accessibility needs?"
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