Mulberry Meadows Community Hub
Fall 2027 Preschool Program Registration - Messy Minds Lab. Ages 3-4. Thursdays 9:00am to 11:30am. January 7 to March 11. Location: 99 Barnham St Ajax
Family Information
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Back
Next
Participant's Information
Participant's Name
*
First Name
Last Name
Participant's Date of Birth
*
-
Month
-
Day
Year
Date Picker Icon
Does the participant have any medical conditions we need to be aware of?
Does the participant have any dietary restrictions or food allergies
Does the participant carry an auto injector for an allergy
*
Yes
No
Does the participant carry an inhaler
*
Yes
No
Back
Next
Messy Minds Lab
Ages 3-4, Mondays January 7 to March 11, 9:00am to 11:30am
Program Confirmation
*
Messy Minds Lab -January 7 to March 11 9:00-11:30am, Thursday
Payment
*
prev
next
( X )
Messy Minds Lab
$250.00 CAD
$
250.00
CAD
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Submit
Should be Empty: