Dakota Learn & Play Child Care Center Waiting List Signup
Please fill out this form to get on the waiting list for the Dakota Learn & Play Child Care Center. If you have more than one child that you are requesting care for, please fill out a separate form for each child.
Sign in to Google to save your progress. Learn more
Email *
Parent First and Last Name *
Phone number *
Address *
Name of child *
Child's date of birth *
MM
/
DD
/
YYYY
Type of Child Care requested *
Days of the Week Requested *
Required
If you have any additional info you'd like to share, please put that below.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Dakota Community Unit School District 201. Report Abuse