Child's Name

Hebrew Name

Child's Current Age Child's Current Age45678910111213

Allergies, Medical Conditions

Does your child have any cognitive or behavioural issues that may affect their academic and/or social experience at school? Does your child have any cognitive or behavioural issues that may affect their academic and/or social experience at school? Yes No

Please check appropriate Grade: Please check appropriate Grade:Junior Kindergarten 1/2 Day Afternoon ProgramSenior KindergartenGrade OneGrade TwoGrade ThreeGrade FourGrade FiveGrade SixGrade SevenGrade Eight

We offer after-hours care M-Th (“Aftercare”) 3:45-5:30 PM. If you require Aftercare, please indicate the appropriate days: We offer after-hours care M-Th (“Aftercare”) 3:45-5:30 PM. If you require Aftercare, please indicate the appropriate days: Monday Tuesday Wednesday Thursday

Additional Children Additional Children 2nd Child 3rd Child

2nd Child's Name

2nd Child's Hebrew Name

2nd Child's Current Age 2nd Child's Current Age45678910111213

2nd Child Allergies, Medical Conditions

Does your 2nd child have any cognitive or behavioural issues that may affect their academic and/or social experience at school? Does your 2nd child have any cognitive or behavioural issues that may affect their academic and/or social experience at school? Yes No

Please check appropriate Grade for your 2nd Child: Please check appropriate Grade for your 2nd Child:Junior Kindergarten 1/2 Day Afternoon ProgramSenior KindergartenGrade OneGrade TwoGrade ThreeGrade FourGrade FiveGrade SixGrade SevenGrade Eight

We offer after-hours care M-Th (“Aftercare”) 3:45-5:30 PM. If you require Aftercare for your 2nd child, please indicate the appropriate days: We offer after-hours care M-Th (“Aftercare”) 3:45-5:30 PM. If you require Aftercare for your 2nd child, please indicate the appropriate days: Monday Tuesday Wednesday Thursday

3rd Child's Name

3rd Child's Hebrew Name

3rd Child's Current Age 3rd Child's Current Age45678910111213

3rd Child Allergies, Medical Conditions

Does your 3rd child have any cognitive or behavioural issues that may affect their academic and/or social experience at school? Does your 3rd child have any cognitive or behavioural issues that may affect their academic and/or social experience at school? Yes No

Please check appropriate Grade for your 3rd child: Please check appropriate Grade for your 3rd child:Junior Kindergarten 1/2 Day Afternoon ProgramSenior KindergartenGrade OneGrade TwoGrade ThreeGrade FourGrade FiveGrade SixGrade SevenGrade Eight

We offer after-hours care M-Th (“Aftercare”) 3:45-5:30 PM. If you require Aftercare for your 3rd, please indicate the appropriate days: We offer after-hours care M-Th (“Aftercare”) 3:45-5:30 PM. If you require Aftercare for your 3rd, please indicate the appropriate days: Monday Tuesday Wednesday Thursday

Father's Name

Father's Phone Number

Father's Email

Mother's Name

Mother's Phone Number

Mother's Email

Full Address Including Postal Code

Which synagogue, if any, are you affiliated with?

DEPOSITS represent your commitment to next year's enrolment. The deposit is $500.00 for the first child and $100.00 for each additional child. The non-refundable charge will be applied to your total parent contributions. We accept Interac payment (email: office@lchds.ca) cheque, or phone the office to provide a credit card. DEPOSITS represent your commitment to next year's enrolment. The deposit is $500.00 for the first child and $100.00 for each additional child. The non-refundable charge will be applied to your total parent contributions. We accept Interac payment (email: office@lchds.ca) cheque, or phone the office to provide a credit card. DEPOSITS represent your commitment to next year's enrolment. The deposit is $500.00 for the first child and $100.00 for each additional child. The non-refundable charge will be applied to your total parent contributions. We accept Interac payment (email: office@lchds.ca) cheque, or phone the office to provide a credit card.

Financial support: Please check this box if you need information about financial assistance that we offer. Financial support: Please check this box if you need information about financial assistance that we offer. Yes