Early Childhood Summer Child Care
PLEASE USE THIS FORM if you need child care services for: children 18 months - children who have yet to attend Kindergarten.

If you are not enrolled at ASA for the 2017-18 school year, you will be assessed a $100.00 registration fee.

Child 1 - First Name: *
Your answer
Child 1 - Last Name: *
Your answer
Child 1 - Birthdate: *
MM
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DD
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YYYY
Child 2 - First Name:
Your answer
Child 2 - Last Name:
Your answer
Child 2 - Birthdate:
MM
/
DD
/
YYYY
Will your family need child care services between June 12th and August 25th? *
Will your family have children in our K-8 summer child care program? *
What days will your child be attending? *
Required
Dates of planned vacations if known:
Your answer
What email(s) would you like us to use to contact you about summer happenings? *
Your answer
Anything you would like to share with us?
Your answer
Submit
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