Child Care Registration Our Lady of Lourdes

Please fill out this form to register your child for Our Lady of Lourdes Child Care Centre.

If you have any questions, please contact us at roshnie.sukraj@tngcs.org.

Today's Date:	Today
Date when Child Care is Required:	Today
Age Group today:
Child's Name:
Child's Date of Birth:
SUBSIDY INFORMATION:
Subsidy Required:
Date Applied for Subsidy:	Today
Client Number:
Full Fee:	Yes No
CONTACT INFORMATION:
Parent's Name:
Home Address:
Cell Number:
Other Phone Number:
Email:
Additional Information:
reCAPTCHA:	Please double-check all information before submitting the application.