2022 Summer Enrollment Form: Little Ones Children's Center
Welcome to the Little Ones Children's Center! Thank you for taking the time to complete this form in its entirety. By completing this form you are requesting to hold your child's spot in the program. Please contact Jenna Carson at jcarson@definition.church or (336) 604-8065 if you have any questions prior to enrollment.
Sign in to Google to save your progress. Learn more
Email *
Child's Name *
First and Last (Optional: Nickname)
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Gender *
Child's Address *
Street, City, State and Zip Code
Second Address (if applicable)
Street, City, State and Zip Code
Sign up by week! Select all the weeks you wish to enroll your child.
Which session would you like to enroll your child?
Clear selection
Age and Grade your child will be going into (if applicable)   *
Day(s) of Attendance *
Required
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms