For Schools - MedicAlert Canada

No Child Without Registration/Information Form

Whether you’re part of the No Child Without program, or would like to join the program, please take a few moments to complete the form below. If you are a parent, please kindly speak to the school administrator to complete the form.

*All fields are mandatory

Is your school already part of the No Child Without Program*?:

Find out if your school is registered by clicking here. If your school isn’t enrolled, please note that there’s currently a waiting list to join the MedicAlert No Child Without program. You may submit your request to be added to the waiting list by completing this web form.

YesNo

Are you requesting on behalf of a public school or Catholic school*?:

If no, please note that No Child Without is currently only available to public and Catholic schools. Click here to learn more about other MedicAlert programs.

YesNo

Information about your school

School Name (in full)*:

School Board (in full)*:

School Address

Unit Number*:

Street Address*:

Province*:

Postal Code*:

Contact Person

First Name*:

Last Name*:

Job Title*:

Phone*:

Email*:

Email Confirmation*:

Secondary Contact Person

First Name*:

Last Name*:

Job Title*:

Phone*:

Email*:

Email Confirmation*:

Request for program brochures

Would you like to receive the No Child Without kit*?:
The kit includes a package of enrollment brochures, poster and a printed Principal Note document.

YesNo

Would you like to receive only the enrollment brochures*?:

YesNo

Brochure Quantity*:

2550

Language*:

EnglishFrench

Enter security code*:

Enter security code: *

If you have an urgent request or have any questions, contact MedicAlert at ncw@medicalert.ca or call 1-877-282-5378 (Monday to Friday, 9am to 8pm, EST).

By submitting your email address, you give permission to MedicAlert Foundation Canada to contact you about the No Child Without program. We do not share any of the school information with any third parties. Please read our privacy policy.

Online Request Form

No Child Without Registration/Information Form

Information about your school

School Address

Contact Person

Secondary Contact Person

Request for program brochures