Registration Request

Looking for care now?

Complete this form if you’re ready to accept a space as soon as a suitable opening becomes available. This request does not confirm enrollment or reserve a space.

Planning for a future start date? Join the Pebble Lane waitlist.

Parent or Guardian

First Name *

Last Name *

Email Address *

Phone Number *

Child and Care Details

Child’s First Name *

Child’s Date of Birth *

Preferred Location *
Select a locationWhite RockSouth SurreyEither location

Program *
Select a programInfant Program (6-15 months)Toddler Program (15-36 months)Early Learning Program (3-5 years)

The Infant Program is available at the White Rock location.

Requested Start Date *

Anything else we should know?

Please don’t include medical, custody or other confidential information here.

I understand that submitting this form does not confirm enrollment, guarantee availability or reserve a space.