YMCA Child Care Waitlist and Registration Application Form

Child's Information

Child's Name(Required)
Child's Date of Birth(Required)
Child's Address(Required)
Does the child you are registering have a sibling(s) in another YMCA of NL regulated child care program?(Required)

Parent/Guardian Information

Parent/Guardian # 1 Name(Required)
Parent/Guardian #1 Address(Required)
Are you actively employed in the health care sector? If yes, ID or confirmation of employment will be required to move from the waitlist to registration.(Required)
Are you actively employed with the YMCA of NL?(Required)

Parent/Guardian #2 Name
Parent/Guardian #2 Address

Program Information

Program(Required)
Preferred Start Date(Required)

Payer Information

Please indicate who will be paying child care fees:

Auto Renewal
Name of Person Completing Form(Required)
Date Completed(Required)