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New Sign-Up Form

Parent/Guardian Name

First Name

Last Name

Phone

(###)

###

####

Child Name

First Name

Last Name

Child Birthdate

YYYY

Enrollment Information

Schedule Options

Additional Care

Early Arrival

After Care

Both

Not at this time

Desired Start Date

YYYY

Siblings

Do any additional children need care? Each child will have their own registration form upon enrollment.

Yes

How did you hear about us?

Enrollment

Pay Deposit

Pay Deposit

Pay Deposit

Pay Deposit

All deposits are $250, non-refundable and are applied to your first month’s tuition. Please do not make any payments until enrollment is confirmed.

Join Our Waitlist.

Parent Name

First Name

Last Name

Program

Desired Start Date

YYYY