Child's Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Phone *

(###)

###

####

Address (Street # and Name) *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Guardian 1 : Name *

First Name

Last Name

Guardian 1 : Cell Phone *

Country

(###)

###

####

Guardian 2 : Name *

First Name

Last Name

Guardian 2 : Cell Phone *

Country

(###)

###

####

Toddler Programs

Select a one program that suits your needs.

Toddler Program 3: 8:00AM - 6:00PM ($771.12)

Pre-school Programs

Select one program that suits your needs:

PreK Nursery 9am-12pm ($294.84/month))

PreK Full-Day 8am-3pm ($589.68/month)

PreK Full-Day Ext 8am - 6pm ($674.73/month)

Kindergarten Programs

Select one program that suits your needs

Kinder Before & After Care ($374.69/month)

Kinder After Care ($257.99/month)

School-age Programs

Select one program that suits your needs

School Age Before & After Care ($569/month)

School Age After Care ($443/month)