Registration form Please enable JavaScript in your browser to complete this form.Parent/Guardian Full Name *FirstLastParent/Guardian Email Address *Child Full Name * Allergies Parent/Guardian Care Medical Information and AllergiesRequested Day Care Schedule *Full-time (Monday to Friday)Part-time (3 days per week)Part-time (2 days per week)Drop-in / Occasional CareAuthorized Pickup Persons (Names and Phone Numbers)Parent/Guardian Consent and Acknowledgement *I certify that the information provided in this Day Care Enrollment Application Form is accurate and complete.I agree to follow all day care policies, procedures, and enrollment requirements.Submit Application
