Monday - Friday
6:30pm-7:30pm
Saturday
12:00pm - 2:00pm
Registration Hours by Appointment Only
6:30pm-7:30pm
Saturday
12:00pm - 2:00pm
Registration Hours by Appointment Only
Special Alert: 20% off registration fee and 15% off 1st week tuition for military, police officer and teachers
Child's Name ________________ Date of Birth _________
Address ________________________________________
Responsible Parent/Guardian Name _________________________
Father's Name ______________ Phone number ___________
Mother's Name _____________ Phone number ___________
Responsible Parent Email Address __________________________
Employment Name _________________________________
Employment Address _______________________________
Employment phone number ______________________
Emergency contact person ___________________________
Relationship _____________________________________
Emergency contact phone number ________________
Recommended by _________________________ (10% off 1 week tuition payment)
When would you like your child to start _________________
What days your child will attend___________________
I will bring my child to Daycare about ______________A.M.
I will pick my child up from Daycare about _____________________P.M.
I UNDERSTAND THERE IS A $ NON-REFUNDABLE REGISTRATION FEE MUST BE PAID UPON ACCEPTANCE OF MY CHILD’S APPLICATION
Parent Signature ___________________________ Date ___________ Director Signature _______________________ Date _____________
Child's Name ________________ Date of Birth _________
Address ________________________________________
Responsible Parent/Guardian Name _________________________
Father's Name ______________ Phone number ___________
Mother's Name _____________ Phone number ___________
Responsible Parent Email Address __________________________
Employment Name _________________________________
Employment Address _______________________________
Employment phone number ______________________
Emergency contact person ___________________________
Relationship _____________________________________
Emergency contact phone number ________________
Recommended by _________________________ (10% off 1 week tuition payment)
When would you like your child to start _________________
What days your child will attend___________________
I will bring my child to Daycare about ______________A.M.
I will pick my child up from Daycare about _____________________P.M.
I UNDERSTAND THERE IS A $ NON-REFUNDABLE REGISTRATION FEE MUST BE PAID UPON ACCEPTANCE OF MY CHILD’S APPLICATION
Parent Signature ___________________________ Date ___________ Director Signature _______________________ Date _____________