Surrey and Cloverdale, BC Childcare Services

Program Registration

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Register for Enrollment

To begin registration for one of our childcare programs, please fill out the form below.
Once submitted, we will contact you as soon as possible to complete the registration. Please make sure you let us know what school your child will be attending. registration forms can be downloaded from our resources page, under "Childcare registration forms" Fill it out and bring them to a location near you. THEY CANNOT BE SENT ELECTRONICALLY. SORRY

Step 1: Parents/Guardians Details

Your E-mail Address
*

Your Name
*

Father's Name

Father's Primary Phone

Father's Work Phone

Father's Cell Phone

Mother's Name

Mother's Primary Phone

Mother's Work Phone

Mother's Cell Phone

Person(s) with whom the child lives with

Step 2: Children's Details

Name of Child
*

Date of Birth (MM-DD-YYYY)
*

Gender
*

Desired Start Date (MM-DD-YYYY)
*

Desired Program
*

Step 3: Validation

Help us prevent spam! 2+12=
*

Step 4: Submit!

All fields with a * are required.

We are licensed by the Fraser Health Authority and are a member of the Options Childcare Resources and Referral organization.
Our "Protect, Provide and Prepare" philosophy ensures your child benefits completely from his or her experience.
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Protect, Provide and Prepare