Member Register

Mother (or Guardian)

Relation to Child

First Name

Last Name

Home Phone

Cell Phone

Address

Postal Code

Work Phone

Work Address

Email Address

Father (or Guardian)

Relation to Child

First Name

Last Name

Home Phone

Cell Phone

Address Check if same as Previous Address

Postal Code

Work Phone

Work Address

Email Address

Child Group	Full Time (100+hrs)	Part Time (<100hrs)
Infant (0-19m) Fee	$1318	$1318
Infant Affordability Grant	$635	$317.5
Toddlers (19m-3yrs) Fee	$1257	$773
Toddler Affordability Grant	$510	$255
Preschool (3yrs+) Fee	$1143	$773
Preschool Affordability Grant	$450	$225

Child Group	Full Time (100+hrs)	Part Time (<100hrs)
Infant (0-19m) Fee	$1468	$1468
Infant Affordability Grant	$635	$317.5
Toddlers (19m-3yrs) Fee	$1442	$927
Toddler Affordability Grant	$510	$255
Preschool (3yrs+) Fee	$1391	$927
Preschool Affordability Grant	$450	$225

Personal

Does Not Apply

First Name

Last Name

Birth Date

Gender

Address where Child resides Check if same as Mother Address

Postal Code

Desired Start Date

Tell us a in a few words about your child so we may become familiar with any behaviours or preferences that he/she prefers or any other comments:

Medical

Health Care #

Physician's Name

Physician's Phone

Medical Concerns

Diet Restrictions

Allergies

Blood group and RH factor (if known)

Is the child's immunization up to date?

Does your child receive medication on an ongoing basis?

If yes, please specify

Amount

Do you authorize us to use non-prescription topical medication to your child in case of emergency (eg. Cuts, severe cough etc.)

Program

Child Group	Full Time (100+hrs)	Part Time (<100hrs)
Infant (0-19m) Fee	$1318	$1318
Infant Affordability Grant	$635	$317.5
Toddlers (19m-3yrs) Fee	$1257	$773
Toddler Affordability Grant	$510	$255
Preschool (3yrs+) Fee	$1143	$773
Preschool Affordability Grant	$450	$225

*Deduct affordability grant from Fee to arrive at parent portion.
*Subsidy deduction will be done after it is received.

Child Group	Full Time (100+hrs)	Part Time (<100hrs)
Infant (0-19m) Fee	$1468	$1468
Infant Affordability Grant	$635	$317.5
Toddlers (19m-3yrs) Fee	$1442	$927
Toddler Affordability Grant	$510	$255
Preschool (3yrs+) Fee	$1391	$927
Preschool Affordability Grant	$450	$225

Third Child Wrap Up

Personal

Does Not Apply

First Name

Last Name

Birth Date

Gender

Address where Child resides Check if same as Mother Address

Postal Code

Desired Start Date

Medical

Health Care #

Physician's Name

Physician's Phone

Medical Concerns

Diet Restrictions

Allergies

Is the child's immunization up to date?

Does your child receive medication on an ongoing basis?

If yes, please specify

Amount

Do you authorize us to use non-prescription topical medication to your child in case of emergency (eg. Cuts, severe cough etc.)

Program

Child Group	Full Time (100+hrs)	Part Time (<100hrs)
Infant (0-19m) Fee	$1318	$1318
Infant Affordability Grant	$635	$317.5
Toddlers (19m-3yrs) Fee	$1257	$773
Toddler Affordability Grant	$510	$255
Preschool (3yrs+) Fee	$1143	$773
Preschool Affordability Grant	$450	$225

*Deduct affordability grant from Fee to arrive at parent portion.
*Subsidy deduction will be done after it is received.

Child Group	Full Time (100+hrs)	Part Time (<100hrs)
Infant (0-19m) Fee	$1468	$1468
Infant Affordability Grant	$635	$317.5
Toddlers (19m-3yrs) Fee	$1442	$927
Toddler Affordability Grant	$510	$255
Preschool (3yrs+) Fee	$1391	$927
Preschool Affordability Grant	$450	$225

Wrap Up

About Chapter1

Chapter 1 Daycare is a childcare and early learning center specifically designed to meet the needs of working families. The center hosts special activities on weekends and is also available for private event rentals to the public. We provide: