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2020-2021 Preschool Registration
Thank you for your interest in our program! Please complete this form, and we will be in touch with you shortly!
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* Indicates required question
Email
*
Your answer
Child's name (First and Last)
*
Your answer
Child's Nickname
Your answer
Child's Gender
*
Female
Male
Child's birthday
*
MM
/
DD
/
YYYY
Has the child attended daycare or preschool before?
*
Yes
No
Is your child potty trained/able to use the bathroom independently? (Without pull-ups)
*
Yes
No
Guardian Name (First and Last)
*
Your answer
Relationship to child
*
Your answer
Address (include city and zip code)
*
Your answer
Primary phone number
*
Your answer
Primary phone type
*
Home
Cell phone
Work
Employer (if applicable)
Your answer
Employer phone number
Your answer
Additional guardian name (First and Last)
Your answer
What is your relationship to the child?
*
Your answer
Additional guardian phone number
Your answer
Additional guardian email
Your answer
Employer (if applicable)
Your answer
Employer phone number
Your answer
Which Program Do You Wish To Enroll Your Child?
*
2 day (Tues/Thurs 8:30am - 11:30am) $125/month
3 day (Mon/Wed/Fri 8:30am - 11:30am) $175/month
5 Day Afternoons (Mon - Fri 12:30pm - 3pm) $300/month
Full Day (Mon - Fri 7am - 5pm) $740
Required
What is your child's t-shirt size?
*
YXS
YS
YM
YL
YXL
If you were referred by a member of our community, please leave their first and last name here.
Your answer
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