New Customer Registration Form

  • WillowTree Children's Society

    About Me Form

  • Child's Details:

  • Child's Date of Birth*
     - -

  • This is an "About Me" form for new children. All sections are optional, Staff will review this to get to know your child and their routines, so we can best meet their needs.

  • Eating

    Parents are responsible for providing lunch and snacks that meet the Canada Food Guide.
  • How does your child drink milk/formula?
  • Can your child use any of the items below? (Select all that apply)
  • Does your child have a good appetite?

  • Sleeping

  • What is your child's night time sleeping pattern?
    Wake Time: Bedtime:

  • What is your child's nap sleeping pattern?
    Morning Nap Times: Afternoon Nap Times:

  • Where does your child sleep?
  • What position does your child sleep in? (Select all that apply)
  • Does your child have a soother when sleeping?

  • Toileting

  • Is your child toilet trained?
  • Does your child let you know when they need to use the toilet?

  • Play Habits

  • Does your child enjoy any of the below? (select all that apply)
  • Does your child have a soother regularly when awake/playing?

  • Discipline

  • Health Information

  • In the last year, has your child had any difficulty with any of the following? Please check yes or no and specify below if yes.
  • Should be Empty: