Child Development Center Registration Form

If you are interested in registering for the Child Development Center, please fill out the pre-registration form below. Fields marked with * are required.

* Child's Name:
* Parent's Name:
* Address:
* Phone:
* Email:
Birthdate:
For school age children:
What was the last grade that your child completed?
Days of attendance (please check the days that your child will attend):
Monday
Tuesday
Wednesday
Thursday
Friday
Arrival time:
Departure time:

Child Care Contract

By completing this form, with my signature and the date, I agree to the stipulations for the chosen payment plan during the contract session of my child's care. I also agree to give two weeks notice if my child will be leaving the program before the end of the session.