Enrollment Inquiry

Enrollment Inquiry Form

Please note: submission of this form does not guarantee enrollment.  This is only a contact form.  In order to hold your spot for an opening or on the waiting list you must download the PDF form, fill it out with your signature and submit a security deposit.  The current form is only good until June 29th, 2020.  If you are interested in enrolling for one of our new programs this summer or next fall then please send a request for an updated enrollment form.

     

    Parent/Guardian Name*

    Parent/Guardian Name

    Parent/Guardian Email*

    Parent/Guardian Phone*

     

    Child's Birthdate*

    Child's First Name*

    Child's Last Name*

     

    What date would you require child care to begin?*

    What days will you need child care for?*
    MondayTuesdayWednesdayThursdayFriday

    What hours will you need care?*

    Has your child been to daycare before?
    yesnever

    If so, reason for leaving?

    Any special needs?

    Other questions