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Full-Day Registration for 2021-2022
This form should be used for half-day registrations only. Please complete this form for the 2021-2022 school year.
Child's Name *
How many days a week will your child attend? Please note the days of the week for each option. *
Parent/Guardian Name(s) *
Address *
Date of Birth *
MM
/
DD
/
YYYY
Primary Phone Number *
Secondary Phone Number
Email Address *
Would you like information on financial assistance?
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Please list any allergies or food sensitivities that your child has. If none, please put none. *
Estimate Pick-Up Time: this information will help us during the staff hiring process and you can change it at any time *
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