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Name & Address

Spell your name as how you want it to appear on any applicable certifications

If creating an account for a child, first create an account for an adult.

Customer Title

First Name

Last Name

Street Address

City, Province, Postal Code

Add Mailing Address(if different from above)

Contact Information

Home Phone

Extension

Work Phone

Extension

Cell Phone

Cell Carrier

Yes, I agree to receive text messages

Email address

Personal Information

Select the Geographic Area for the Municipality in which you currently reside or work at within York Region.

Role in Family

Gender

Users must be 13 years of age or older.

Date of Birth

Head of Household

Customer Type

Geographic Area (Reside or Work)

Questions

Emergency Contact

For children, please enter Emergency Contact information, ideally this should NOT be the parent or guardian.

First Name

Last Name

Relationship

Home Phone

Extension

Other Phone

Extension

Add another Emergency Contact

Account Information

Email address

Add Alternate Login ID

Password

Contain at least eight characters in length

Contain at least one letter and one number

Confirm Password

By creating an account, you are agreeing to terms of use and privacy rights.

Regional Municipality of York:
Terms of Use | Your Privacy Rights

Active Network, LLC:
Terms of Use | Copyright Policy | Your Privacy Rights

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