Edgewood Child Care Program, Inc.

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Child’s first and last name *

Child's nickname (if applicable)

Child's Date of Birth
*

YYYY

Child's Sex *

Female

Male

Other

Child's Teacher *

Child's grade
*

Kindergarten

First Grade

Second Grade

Third Grade

Fourth Grade

Fifth Grade

I acknowledge that I must pay two week’s of tuition (ranging from $18 - $70/week) per child after I register. I will receive a request via email. *

I agree

Required

I acknowledge that there is a one time $12 registration fee per child, in addition to the weekly fee. *

I agree

Required

I acknowledge that if there is a balance on my account from last year, I must pay it before my child can enroll this year.

I agree

Required

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