Child Name *

First Name

Last Name

Child Date of Birth *

MM

DD

YYYY

Parent Name *

First Name

Last Name

Parent Phone *

(###)

###

####

Second Parent/Guardian Name

First Name

Last Name

Second Parent/Guardian Phone

(###)

###

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I am most interested in the following: *

Preschool Only 2 day T/Th

Preschool Only 3 day M/W/F

Preschool Only 5 day M-F

Preschool with 3:30 Extended Day 2 day T/Th

Preschool with 3:30 Extended Day 3 day M/W/F

Preschool with 3:30 Extended Day 5 day M-F

Preschool with 5:30 Extended Day 2 day T/Th (available in 24-25)

Preschool with 5:30 Extended Day 3 day M/W/F (available in 24-25)

Preschool with 5:30 Extended Day 5 day M-F (available in 24-25)