STEP 1:  INTEREST APPLICATION FORM
Application for kids aged 18 Months to 6 years
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Welcome to Step 1, filling out this form will place you on the wait list for Camelot Kids. You application is not finalized until we receive your non-refundable application fee of $50.00. You can submit your fee with your printed confirmation of this completed form via: mail or in person at our front office.
For any additional questions please contact our front office at 323-662-2663
Child's First Name *
Child's Last Name *
Child's D.O.B. *
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Does your child have siblings? *
If yes please tell us how old?
If applicable, Is your child a twin?
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Does your child have any allergies or special health concerns? *
If yes, please explain.
Parent A First Name: *
Parent A Last Name: *
Address: *
City: *
Zip: *
Home Phone: *
Cell Phone: *
Email: *
Occupation: *
Parent B First Name: *
Parent B Last Name: *
Address: *
City: *
Zip: *
Home Phone: *
Cell Phone: *
Email: *
Occupation: *
Marital Status: *
I would like to enroll my child in: *
Required
Program Request: *
Please select availability
Required
Schedule Request *
Please select availability
Required
I would like to enroll my child starting: *
How did you hear about us: *
Notes or Questions?
Name of person filling out form *
Date Submitted *
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Office Use Only
Check #
Date Received
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