2024-2025 Registration Form (General Public)
IMPORTANT PLEASE READ
Space is VERY limited.

Fill out your form and submit it. 
THERE IS NO COST TO FILL THE FORM OUT!!!
DO NOT MAKE ANY PAYMENTS

If we are able place you on are roster we will be in touch with more details and instructions.

OLDER & YOUNG TODDLERS ARE FULL 
The other age groups only have a handful of spots available!





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Email *
Child's Name *
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Sex *
Parent #1 Name & Address *
Parent # 1 Phone Number *
Parent # 2 Name & Address *
Parent # 2 Phone Number *
Parent # 2 Email Address *
Age Group (Choose one) Age on August 31st *
Day of the Week (1st choice) 
ONLY OPTION FOR 4'S IS M-TH OR M-F
 *
Day of the Week (2nd choice) 
ONLY OPTION FOR 4'S IS M-TH OR M-F
 *
Any Previously Attended School *
Place of Worship *
Child's Pediatrician Name & Number *
Allergies *
Please explain any allergies
Emergency Contact (OTHER than parents) 
Name & Number
 *
Name of person filling this form out *
A copy of your responses will be emailed to the address you provided.
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