ErinoakKids - SmartStart Hub Registration Form

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Child First Name

Child Last Name

Date of Birth

Parent/Guardian Name

Parent/Guardian Contact Number

Text area

Unit Number

Street Number

Street Name

City

Province

Postal Code

Are interpreter services required?

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This form is being submitted with the knowledge and consent of named parents/legal guardians. ErinoakKids will always treat your personal details with the utmost care and will not share or sell your personal information. You may unsubscribe from receiving communications from ErinoakKids at any time. We are committed to keeping your information safe and confidential. We follow the rules set out in law about collecting, using and disclosing your personal information. For more information, please review our privacy policies publicly posted at https://www.erinoakkids.ca/privacy.