Registration Form

Please complete and submit the form below to begin your registration with Mighty Minds Montessori and a representative will be in touch with you

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Title *— Select Choice —Mr.Mrs.Ms.

Name *

First

Last

Address *

Street Address

City *

Province *

Postal Code *

of Code Time,

Phone Number *

Email *

Child 1 Name *

First

Last

Date of Birth *

Child 1

Child 2 Name

First

Last

Date of Birth

Child 2

Child 3 Name

First

Last

Date of Birth

Child 3

How did you hear about us?From a Family currently enrolledFrom a friendFacebookInstagramGooglePrint AdvertisingStreet signOther

Do you require Full Time, Part Time and/or Extended Hours care?Full TimePart TimeFull Time (& Extended Hours)Part Time (& Extended Hours)

Which days do you require care?

• Monday
• Tuesday
• Wednesday
• Thursday
• Friday

Please select all that apply

What is your anticipated start date?

Questions/Comments

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