Cedarvale Ravine Winter RegistrationPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 5Child's Name *FirstLastChild's Date of Birth *Child's AgePreferred pronounShe / HerHe / HimThey / ThemPrefer Not To SayPlease choose your program(s) belowSaturday 10am-11:30am (Caregiver/Child) Suydam Park entranceSaturday 1pm-3pm (ages 4-8) Suydam Park entranceSunday 10am-12pm (ages 4-10) Suydam Park entranceSunday 1pm-3pm (Ages 4-10) Suydam Park entranceMonday 3:30pm-5:30pm (Ages 4-10) Markdale Preschool entrance (JR Wilcox Pick up available)(FULL) Wednesday 3:30pm-5:30pm (Ages 4-10) Markdale Preschool entrance (Leo Baeck Pick up available)Thursday 3:30pm-5:30pm (Ages 4-10) Markdale Preschool entrance (Cedarvale PS Pick up available)PA DaySept 27th (9am-3pm)Aftercare (3pm-4pm)Leo Baeck school pick up YesNoJR Wilcox school pick up YesNoCedarvale PS school pick up YesNoIf you have a group or are interested in a day/time that is not listed above, please provide this information here. Please note, we will do our best to accommodate your request. If the program you are interested in is full, we will add you to the waitlist and let you know when a spot opens up.NextParent/Guardian Information *FirstLastParent/Guardian 1 Preferred pronounShe / HerHe / HimThey / ThemPrefer Not To SayParent/Guardian 1 Email *Parent/Guardian 1 NumberAddressAddress Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryParent/Guardian 2 InformationFirstLastParent/Guardian 2 EmailParent/Guardian 2 NumberNextEmergency Contact Name *FirstLastEmergency Contact NumberEmergency Contact Email *Relationship to ChildApproved Names for Pickup (please separate names with a comma)NextDoes your child have any food, medication or environmental allergies *NoYesPlease list and explain any allergiesDoes your child's allergy require an Epi PenNoYesDoes your child have a special health or medical condition?NoYesPlease explain here any special health or medical condition.Please provide any additional information about your child that would be useful for Roots 2 Rise staff to be able to best support your child's needs (i.e. emotional, cognitive, behavioural, physical, etc.)NextName *FirstLastEmail *Date / TimeSubmit