Name

Email

Phone

Preferred method of contact Preferred method of contact Phone Email

Child's Name

Age of child/children

Program/Age Group Program/Age GroupInfants (18 mo or under)Toddlers (1 to 2½ years old)Preschool (2½ to 4 years old)Kindergarten (5 years old)School-Age (6 to 12 years old)

Location of Interest Location of InterestBriarcrest (Etobicoke, ON)Buttonwood (Etobicoke, ON)Cooksville (Mississauga, ON)Duffin's Bay (Ajax, ON)Greensborough (Markham, ON)Kennedy (Scarborough, ON)Maple Hill (Barrie, ON)Mapleview (Barrie, ON)Newmarket (Newmarket, ON)Thickson (Whitby, ON)Vaughan South (Woodbridge, ON)(more than one, specify in additional details)

Additional details

Day of the week Day of the week Monday Tuesday Wednesday Thursday Friday

Time Time Daytime (9am to noon) Late afternoon (3pm to 5pm)

Please select Please select Friend/Family member Parent of a Learning Jungle student Online search Social Media (Instagram, Facebook) Drove by the facility Media/Advertising Local Event Other