KINDLY PRINT THIS FORM , SIGN IN ALL PLACES AND HAND IN TO JACKIE FOR THE REGISTRATION TO BE COMPLETE. BY ADDING YOUR EMAIL ADDRESS IN THE "FAMILY EMAIL ADDRESS" BOX IT WILL BE SENT TO YOU READY FOR PRINTING AND SIGNATURE
Under the Day Nurseries Act, Section 33, in order to attend Ontario Child Care Facilities, children must have proof of immunization against diphtheria, pertussis (whooping cough), tetanus, polio, haemophilus b, and measles, mumps and rubella. Immunization against measles, mumps and rubella must have been given after the 1st birthday.
Male
Female
Contact the Immunization Team at 1-877-794-1880 if:-
- This child needs an exemption from immunization against any disease listed for medical, religious or conscience reasons, or
- This child does not have an immunization record, or
- You have any questions about this form
CHILDREN MUST BE ADEQUATELY IMMUNIZED IN ORDER TO ATTEND A CHILD CARE FACILITY