Daycare Registration RM_StatsDaycare InformationCompany InformationDaycare Name *Street Address *City *Province *Select an optionAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorth West TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonPostal Code *Company Phone *Alternate PhoneEmail *WebsitePlease include the http:// at the front of your website addressGovernment License Number *Multiple Licenses? * Yes No Enter other government license numbers (if applicable)Please enter one license per lineAvailability by AgeAges Enrolled * Infants Age 2 Age 3 Age 4 Ages 5 to 12 Contact InformationFirst Name *Last name *Title *What is your role at the daycare?Work Location *If your daycare has multiple locations, which one do you work at?Work PhonePlease enter your phone number like this: 000-000-0000Cell PhonePlease enter your phone number like this: 000-000-0000Best day to contact you * Monday Tuesday Wednesday Thursday Friday Saturday Sunday You can check multiple days if you'd likePreferred method for contact * Call company phone Call cell phone E-mail company e-mail E-mail personal e-mail Text to cell phone Terms of SubscriptionDaycare Type *Select an optionPrivate Daycare Center ($ 199)Non-profit Daycare Center ($ 199)Community Daycare Home ($ 129)Confirm subscription * I would like to register for one year of service from Daycare Quick Connect. I am aware by registering that my credit card will be charged in the amount of $199.00 on the date of registration Confirm Renewal * I am aware that on my annual anniversary date, my credit card and DQC Service will be automatically renewed and my account will be charged the annual subscription fee. Terms and Conditions (scroll to bottom before checking box) *I understand and agree with the following terms and conditions1. I understand DQC Inc. is not responsible for any registered staff's actions or conduct and will not not hold DQC Inc. responsible for any wrong doing or misconduct. 2. I understand that DQC Inc. is not responsible for any wages to be paid to any staff profile, that all wages are the responsibility of the hiring daycare center. 3. I understand that the center is conduct themselves in a professional manner and comply with all New Brunswick Employment Standards, Work Safe NB standards and all government policies as to staffing and wages. 4. I understand that the center is to immediately complete all necessary government paperwork that pertains to hiring for a licensed daycare center in New Brunswick, such as but not limited to QIFS, SD Checks (specific to the center), etc.