2022-23 Registration Form for Chai Tots Preschool & Daycare

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Register your child now for the ultimate day care experience for (Summer and) Fall 2022!

1) Make sure to get a confirmation after submitting this form.
2) A link will be sent to you; make sure to sign up with FACTS to complete your registration process.

Child's Last Name *

Child's First Name *

Child's Gender *

Female

Male

Not born yet

Child's Date of Birth *

YYYY

How old will your child be in September 2022 *

Daytime Phone Number *

Evening Phone Number *

Father's Last Name *

Father's First Name *

Father's cellphone number *

Father's Email Address *

Most correspondence is sent via email. To ensure receipt of all important school information, including calendar updates, please provide your email address below.

Mother's Maiden Name *

Mother's First Name *

Mother's cellphone number *

Mother's Email Address *

Most correspondence is sent via email. To ensure receipt of all important school information, including calendar updates, please provide your email address below.

Street Address: *

City *

State *

Zip Code *

I am signing up my child for: *

Both - Summer 2022 and Fall 2022-2023 (SAVE $125)

Summer 2022 (summer only applications should stop here and fill out the Summer only form: https://forms.gle/2NcTodgHYkRejB5NA)

Fall 2022-2023

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