Register Your Child

Complete one registration for each child you are enrolling. When you are finished registering all children, you will continue to payment.

Only one registration fee is required per family.

Child information

Child's First Name *

Child's Last Name*

Date of Birth*

Enter the primary parent or guardian first. You may add another parent or guardian when applicable.

Relationship to child *

Full name *

Email *

Cell phone *

Work phone

Would you like to add another parent or guardian? *

Yes No

Street Address*

City*

State*

Zipcode*

Choose information your family can remember but that is not easy for someone else to guess.

Pick-up Authorization Phrase (2-3 words)*

Door Access Code (4-digits) *

Child Gender*

Male Female

Days Attending*

Mon Tue Wed Thu Fri

Child Start Date*

Hours Attending*

Full Time
3 Hours (9am-12:30pm)
6 Hours (9am-3:00pm)
Before Care (7-9am)
Before Care (8-9am)
After Care (2:30pm-closing)
After Care (3:30pm-closing)

Additional Comments (if any)

How Did You Hear About Us?*