Roots Education Inc. | Daycare Registration

Interested to enroll? Please fill out the form (below) to begin the registration process and receive additional information.

We look forward to speaking with you.

Please note that this is a secure page and any information provided will be kept strictly confidential.

Child's First and Last Name

Child's Date of Birth

First and Last Name

Phone Number

Home Address

First and Last Name

Phone Number

Home Address

Health Information (health issues, allergies, etc.)

Start Date

Payment

Subsidy Parent fee

Additional Comments

Roots Daycare Registration