Childcare Services Enrollment Form              Lakeside Day Care
Julie Vysotsky, Supervisor of Child care


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Enrollment Information
Thank you for choosing Childcare Services!  We look forward to welcoming your child in our learning community. Children must be at least 3 years old and potty trained to be eligible for admission.  Please complete one enrollment form for each child enrolled.

This form is the FIRST STEP in enrolling your child.  

Space is limited.  Please complete and submit form as soon as possible.


Fees:
A $25 family, non-refundable enrollment fee (payable to NRESC) is required upon enrollment. This fee is separate from the tuition fee. 

Last month's tuition for June 2025 is expected when the NRESC has sent you notification that your registration is accepted in order to reserve a place for your child.  

There are no refunds, deductions or make-up days for missed time due to illness, vacations or any other circumstances.
Please be advised,  Childcare Services/ PLDC follows the Pompton Lakes School District Calendars.  You can find the calendar on the Pompton Lakes School District website. 

Please be advised there is no longer an "on demand" option for the PLDC.  You must register for a 2, 3 or 5 day program as indicated below.

ENROLLMENT DEADLINE: July 1, 2025

Parent/Guardian Information
Parent/Guardian #1 First & Last Name *
Parent/Guardian #1 Email Address *
Parent/Guardian #1 Phone *
Parent/Guardian #2 First & Last Name *
Parent/Guardian #2 Email Address *
Parent/Guardian #2 Phone *
Enrollment information
Child's Last Name *
Child's First Name *
Child's Date of Birth *
MM
/
DD
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YYYY
How old will your child be on October 15, 2025? *
 I would like to enroll my child in the following FULL DAYS (8:00am-3:00pm) program: *
Please choose which 4, 3, or 2 days your child will be attending Day care: *
Required
I would like to enroll my child in the following Half-Day (8:00am-11:30am) program: *
Please choose which 4, 3, or 2 days your child will be attending Day care: *
Required
Provide the name of the person completing this form.
Pay Here
https://www.payschoolsevents.com/events/details/21562
I acknowledge that submission of this form does not automatically enroll my child into Child Care Services.  I will be notified that my registration has been accepted.  *
A copy of your responses will be emailed to the address you provided.
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