Child Enrollment Request Form
Pulse of Life Church childcare enrollment application form for families seeking to enroll at Pulse of Life Kids Care Center or to be added to our waitlist. Please submit one application per child.
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Email *
Are you requesting free or reduced cost childcare assistance?
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Are you currently displaced from your home?
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Do you have access to vaccination records for your children?
 *
Name of Parent(s)
Address
Primary phone number
Primary email address
 *
Child's name
 *
Child's date of birth
 *
MM
/
DD
/
YYYY
Number of siblings
 *
Desired start date
 *
MM
/
DD
/
YYYY
Which plan are you wishing to sign up for?
 *
Required
Which date(s) do you wish to start childcare?
 *
Check which prepared meals you wish us to provide
 *
Required
For infants, please describe the child's feeding program.
Do you participate in the SD Family Assistance program for tuition payment assistance?
 *
NOTE
Thank you for your interest in our church daycare. Please allow 1 day for processing. Someone from our enrollment team will get back to you as soon as possible. For immediate assistance, please email childcare@pulseoflife.org or call 605-659-4744. Our rates are available online at www.pulseoflife.org/childcare.  You may qualify for SD Family Assistance to help with paying your childcare expenses; You can apply at SD DSS.
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