PEACE Night Childcare Registration Form

PEACE Night Childcare Registration Form

Killarney School, April 23rd from 6:30 pm to 8:30 pm
Montessori Alternative Public School Society

We are pleased to offer on-site childcare during PEACE Night, provided by Sprog & Sprocket. Their experienced team will create a fun, engaging, and safe environment for children ages 3 and up.Children will enjoy an exciting evening filled with entertainment and hands-on activities, including a ball pit, soft play, building activities, and more. The space is thoughtfully designed to keep children active, happy, and well cared for while you attend the event.Sprog & Sprocket is known for their high-quality programming and attentive staff, giving parents peace of mind throughout the night.Spaces are limited, so please register in advance to secure your child’s spot.
Parent #1 Name*

First NameLast Name
Parent #2 Name

First NameLast Name
Child's Name*

First NameMiddle NameLast Name
Child's Birth Date*

MonthDayYear
Name

Family DoctorAlberta Health #
Child's Gender*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Primary E-mail*
example@example.com
Secondary E-mail
(optional)
Parent #1 Primary Phone Number
Format: (000) 000-0000.
Parent #2 Primary Phone Number
Format: (000) 000-0000.
Emergency Contact

NamePhone Number
What should we know about your child?
Allergies, Developmental needs, ETC
Additional Comments
If not full-time, please indicate preferred schedule.
Should be Empty:

Montessori Alternative Public School Society