Summer Daycare Registration Form

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Summer Daycare Registration Form

Our Summer Daycare program is open to students in Jr. K - 3rd grade. The program will run from July 6th - 31st. The fee is $900.00 for the 4-week session.

* Indicates required question

Student Name *

Your answer

Age *

Your answer

Current Grade (this is the grade completed in June 2020) *

Choose

Jr. Kindergarten

Kindergarten

First Grade

Second Grade

Third Grade

Parent 1 Name

Your answer

Parent 2 Name

Your answer

Street Address

Your answer

City

Your answer

Zip Code

Your answer

Emergency Contact Number

Your answer

Email Address

Your answer

Comments

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