181 Main St S

Georgetown, ON L7G 5S2


Maple Nursery School

Mon - Fri: 9:00am - 11:30am

Office Hours

Register Your Child

Program Selection

  • Toddler program operates Monday to Thursday

  • Two day program options are available Monday/ Wednesday or Tuesday/Thursday. Exceptions may apply.

  • Three day Pre-school program is available Monday/ Wednesday/ Friday. Exceptions may apply.

  • If your program of choice is not available you may be placed on a waiting list.

    Child's Information

  • Do both parents have custody of the Child?

    Parent 1's Information

    Parent 2's Information

    Physician's Information

    Emergency Contacts

    Contact #1

    Contact #2

    Individuals Authorized to Pick Up Child

    Contact #1

    Contact #2

    Individuals NOT Authorized to Pick Up Child

    Child's Medical Information

    The Day Nursery Act 1986 Regulation 160, Section 7(i) requires the following medical information. This information will be kept in your child's confidential file along with their registration package.

    Special medical conditions or known allergies

    Has your child ever had a COMMUNICABLE disease such as Measles, Mumps, Rubella, Chicken Pox or Whooping Cough? If Yes, please indicate which and when.

    In the event of an emergency, please advise as to an individual action plan and the sequence it should occur (Eg. contact parent via cell, administer medication, dial 911) or state how circumstances would dictate depending on the emergency and it would of the discretion of the person responsible for your child.

    Does your child require any special considerations in respect to diet, rest or exercise? If yes, please describe.

    Does your child possess any physical disabilities? If yes, please describe.

    Does your child possess any emotional disorder or behavior problems? If yes, please describe.

    Does your child require medication regularly? If yes, please describe.

    Other Information

    How did you hear about us?

    Please indicate whether you possess any special skills/talents/opportunities that you feel may benefit Maple Nursery School or the children directly.