Riverside Christian Montessori - Haldimand County | Registration

If you would like to register for our 2018/2019 School year or would like to be on a waitlist for future years, please fill out the following form.

Fall Program Dates: September 04, 2018 – June 21st, 2018

Online Registration Form:
- Child's Name*
- Date of Birth*
- Home Address*
- Home Phone Number*
- Email*
- Father's Name / Occupation*
- Father's Contact Number*
- Father's Address if different than above
- Mother's Name / Occupation*
- Mother's Contact Number*
- Mother's Address if different than above
- Languages Spoken at Home*
- Dietary Restrictions & Allergies*
- Doctor's Name*
- Doctor's Address*
- Doctor's Phone Number*
- Emergency Contacts other than parents*
- Is there anyone other than yourself to whom your child can be released to?
- Are you interested in registering your child for the fall program?
- Which days of the week are you interested in sending your child to the program? Please specify if there are differences for summer / fall registration if interested in both programs.