Please read these directions:
  • Please fill out the form below for each child you are signing up for Early Care.
  • There is a $25 registration fee per child.
  • Weekly Fees: $35 per week for 1 child or $40 per week for 2 or more children.
  • Pay Early Care Fees Here
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What is your child's name? *
What is your child's current grade? *
What is the name of your child's homeroom teacher? *
Mother's Name/Phone Number? *
Father's Name/Phone Number? *
Mailing Address? *
Email Address? *
Emergency Contact Person #1/Phone Number? *
Emergency Contact Person #2/Phone Number? *
Doctor's Name/Phone Number? *
Does your child have any known allergies? *
Does your child have any speech, hearing, or visual problems? *
Has there been any recent traumatic situations the child has been exposed to such as a death in the family, divorce, new sibling, etc? *
What is your child's temperament? *
Does your child have any food restrictions? *
Can your child be relied upon to indicate bathroom wishes? *
Are there any siblings? Please name them and specify the grade they are in. *
What language is spoken at home?
Are there any other comments or information you would like to let me know about? *
Early Care Behavior Policy *
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