Stars for Life Childcare Inquiry Form

Stars for Life Childcare Inquiry Form

Please complete the form below to express your interest to register your child with us. We will contact you as soon as possible to discuss available options and further details.
Location
West Vancouver: 1068 Inglewood Ave, West Vancouver, BC V7T 1Y3

New Westminster Unit: 121 E Columbia St, New Westminster, BC, V3L 5E4
Choose which Stars for Life you are interested in
Parent Name
First Name*
Last Name*
E-mail*
Phone*
Your Location:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child's Name:
Name*

First NameLast Name
Date of birth*

MonthDayYear
Date
What days do you require daycare?*

All weekMondayTuesdayWednesdayThursdayFriday
Daycare Time Requirements:*

Full TimePart TimeMorningAfternoon
Has your child attended daycare before?

YesNo
Preferred start date:*

MonthDayYear
Date
How did you hear about us?
Message
Should be Empty:

Location