JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Lakeshore Daycare Childcare Needs
We need to know what you need from us. Please fill this out as best you can and someone will contact you. Please be patient as we prepare for a safe re-opening.
Sign in to Google
to save your progress.
Learn more
Parent Name
Your answer
Parent Contact Email Address
Your answer
Parent Home Phone Number
Your answer
Parent Cell Number
Your answer
Child's name
Your answer
Child's date of birth
Your answer
Program
Choose
Toddler
Preschool
JK/SK
Latchkey
Will you need summer care?
Your answer
Full/Part time?
Your answer
For which program?
Choose
Toddler
Preschool
JK/SK
Latchkey
What days each week? (minimum of two)
Monday
Tuesday
Wednesday
Thursday
Friday
What is the exact drop off time? (as close to the actual time as possible)
Your answer
What is the exact pick up time? (as close to the actual time as possible)
Your answer
Did you utilize an Emergency Daycare during the Pandemic closures? If yes, what is the name of the daycare?
Your answer
Do you require or have approved subsidy?
Your answer
Will you require child care in the fall or when schools re-open?
Your answer
For which programs/age group
Choose
Toddler
Preschool
JK/SK
Latchkey
Please specify which days and times (ie. Full day/half day, Before and/or After school)
Your answer
Thank you for your interest in Lakeshore Daycare for your childcare needs.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
