Andrew Fleck Children's Services - Perley Health Intergenerational Child Care Centre Waitlist

Child's Name (First & Last):*

Child's Date of Birth or Due Date:*

Date

Name of parent/guardian who is employed by Perley Health:*

If more than one parent is an employee of Perley Health, please indicate the parent with the earliest date of hire with Perley Health. AFCS will verify each applicant’s employment status and date of hire with Perley Health Human Resources Department .

Perley Health Email Address:*

Personal Email Address (Optional):

When are you hoping to start child care?*

When the centre first opens in Spring 2026Between Spring 2026 and September 2026Around September 2026At a later date in the future