Crossroads Daycare Enrollment Form
Opening August 2018
Now Enrolling for 2018 - 2019 Season

Extended Daycare Hours
6:00 a.m. - 630 p.m.
Monday - Friday

Administration fee of $150 due with enrollment (non-refundable)

Contact our Daycare administration to make payment arrangements.
Tel 317-838-9100 Email daycare@welcometocrossroads.org
Online payment coming soon.

Email address *
Guardian/Parent Name *
Your answer
Phone number *
Your answer
Child Name 1
Your answer
Date of Birth
MM
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DD
/
YYYY
Child Name 2
Your answer
Date of Birth
MM
/
DD
/
YYYY
Child Name 3
Your answer
Date of Birth
MM
/
DD
/
YYYY
Child Name 4
Your answer
Date of Birth
MM
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DD
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YYYY
FULL TIME DAYCARE Monday - Friday
PART TIME DAYCARE - MINIMUM 3 DAYS A WEEK
For Part Time Daycare: Tell us your days and time preferences
Your answer
For both Full and Part time Daycare:
Material/Activities fee due along with first tuition fee
Preschool $125
Toddlers $100
Infants $50


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