Application Form - School Age Program

Please complete the form below and submit. Alternatively, please download a fillable PDF and return by email to schoolageprogram@terrace.ca or drop off at the Sportsplex Reception, 3220 Kalum Street during regular business hours.

Please be aware that completion of an application form does not guarantee enrolment in our program. Enrolment is based on demand and capacity.

You will be contacted following submission of the application form. An enrolment form will need to be completed when your child is accepted in the program.

If a space is not immediately available, you can choose to place your child on the waiting list to allow enrolment when space does become available.

I am applying for:

Daily Child Care

NID Only

Child Information

Child's Legal Name

Child's Preferred Name

Birthdate

Gender

Child's Primary Address

Address

City/Town

Province

Postal Code

Family Information

Parent/Guardian #1

Name

Phone

Parent/Guardian #2

Name

Phone

Care Required

Do you require before-school care?

Do you require after-school care?

What school does your child attend?

What grade is your child in?

Are you registering other children from your family in the program? (Please list names of the other children being registered.)

Please note: each child needs to be registered separately.

CAPTCHA