Parents Name: Childs Name: Childs Date of Birth: Day Time Telephone Number: Home Telephone Number: E-mail Address: Date Care is Required: Program: Infant (6 weeks - 18 months) Toddler (18 months - 30 months) Preschool (2 1/2 - 4 years) JK (4-5 years) SK (5-6 years) Preferred Location(s): (Please choose all that apply)     Dixie, Mississauga South Service Rd, Burlington   Erin Mills, Mississauga (No Infant Program Available) Maple Ave., Milton   Sandalwood, Brampton Sheldon Drive, Cambridge   Victoria St., Kitchener Yonge St., Newmarket (Full-Time Infant Program Only)   Queen St., Brampton Matheson, Mississauga   Winston Churchill, Oakville Wolfedale, Mississauga   Trowers Rd., Vaughan Third St., Orangeville   Traders, Mississauga Escarpment Way, Milton   Mill Street, Acton Full Time   Part Time any two days any three days any four days   Monday Tuesday Wednesday Thursday Friday  Are you receiving or have you applied for subsidy?: YesNo  How did you hear about Peekaboo? I accept the terms of the Privacy Policy