Waitlist
Please fill out the form as much as possible in order to be added to our waiting list. If you have multiple childen to add to our wait list, please fill out this form for each child.
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Which location do you prefer?
Bermuda Dunes 42115 Yucca Ln, Bermuda Dunes CA 92203 OR Palm Desert 47549 Hwy 74, Palm Desert CA 92260
 *
Required
Parent's First and Last Name *
Email *
Phone number *
Child's First and Last Name *
Child Gender *
Required
Child's Date of Birth or Due Date *
MM
/
DD
/
YYYY
Is your child potty trained? (Ages 2+) Please explain 
Are you needing full time or part time care?  *
If needing part time care, what days do you need care for? (Please check all that apply)
If you need after school care, which school does your child attend currently? At this time we are only accepting school age children from these schools only.
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If your child is in elementary school, what grade are they in?
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What is your anticipated start date? *
Are you currently on Financial Aid? *
If you are interested in Financial Aid, please check this flyer to see if you qualify.
If interested in applying for financial aid, please add your monthly gross income (before taxes) for your household total.
If interested in applying for financial aid, please add the number of people included in your household size. Up to 2 adults and all children under age 18.
Comments; Anything we should know about your child.
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