Child Waitlist Form - School Age Program

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This form will be used to put your child on the waitlist for our School Age program Ages 4 Years to 12 Years) at S.P.L.A.S.H. Child Care Inc. located at 233 McKenzie St. Once the form is complete, you will hear from someone to book a tour of the program (NOTE: tours are required before starting any of our programs)

Email *

Is your child enrolled in school? *

Yes

If your child is enrolled in school, which school are they enrolled in?

Child's Full Name *

Child's Birthdate *

YYYY

Parent's Names *

Contact Info (Please include: Home address and Phone number to be reached at) *

Anticipated Start Date *

YYYY

Child's Allergies (if no allergies, please type None) *

Submit

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