EarlyON Program Registration "*" indicates required fields ADULT - First and Last Name* Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920ADULT - First and Last Name (if applicable) Date of BirthMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Relationship to Child* Parent Careprovider Grandparent Other Email Address Phone #* Address* Address City/Town Province Postal Code Emergency Contact Name* Emergency Contact Phone #* According to CASL Anti Spam legislation we require permission to email you any information regarding our special events and programs.* Yes, please email No, I don't wish to receive information via email Children Details:*Child's First and Last NameChild's DOB Add RemoveIf registering more than one child, click on the + sign on the right to add another line for the next child.Consent*I grant permission to EarlyONCFC and its employees to take photographs, videos or video recordings to promote, publicize or explain the EarlyONCFC along with their activities and functions and for administrative, educational purposes. I acknowledge that EarlyONCFC owns all rights to the images and recordings. I further grant permission to EarlyONCFC to reproduce, use, exhibit, display and broadcast works of these images and recordings and name in any media known or later developed. I further grant consent under the Municipal Freedom of Information and Protection of Privacy Act to EarlyONCFC to collect and disclose my image, voice likeness and name for promoting, publicizing or explaining the EarlyONCFC. Yes No NameThis field is for validation purposes and should be left unchanged. * Please ensure are required fields (marked with *) are entered correctly. Back to EarlyON page