Sunshine Program - Online Registration

Child's full name

Current age

Gender

Address

City/Town

Province

ZIP/Postal Code

Date of Birth

Medicare number

(Please indicate any allergies, medical conditions or other information about your child and any instructions on care. Note that while we aim to offer an inclusive program, children must be able to self-care (bathroom) and able to be supervised and participate in a group setting.

Medical conditions

List any siblings also being registered.

Location

Primary Parent/Guardian

Name

Relationship to child

Address

City/Town

Province

ZIP/Postal Code

Telephone

List any other guardians who have permission to retrieve your child.

Day-time Caregiver

Name

Telephone

The Sunshine Program staff has my permission to use my or my child’s photograph publicly to promote the program. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

Yes, I give my permission.

No, I do not give my permission.

I understand and acknowledge that the City of Saint John Sunshine Program requires a responsible guardian be available for the daily care of my child and that this person is immediately available to retrieve him/her as required.

Yes

I have read and understand the Release Agreement.

Yes

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Sunshine Program - Online Registration

For Emergency Contact 9-1-1