Elementary Building Student will attend during the 2020-2021 school year *
Parent/Guardian Name (mom) *
Your answer
Parent/Guardian (mom) cell phone number *
Your answer
Parent/Guardian (mom) Email address *
Your answer
Parent/Guardian Name (dad) *
Your answer
Parent/Guardian (dad) cell phone number *
Your answer
Parent/Guardian (dad) Email address *
Your answer
Name and Grade of Siblings currently enrolled in Child Care program *
Your answer
Which Child Care Days are you applying for? *
Child Care tuition schedule: Daily fee: $20.00 or Weekly fee: $80.00. Payments must be made the week prior to service. Your first weeks tuition will reserve your students placement in the program, and is due one week prior to attendance. Please remit payment to: Lakeview Child Care 15 Arbor Street Battle Creek Mi 49015.
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