CCDC PRESCHOOL & SCHOOL AGE REGISTRATION
PLEASE READ THIS SECTION BEFORE CONTINUING:

Registration forms must be filled out completely. The $50.00 registration fee is due with this application to hold your spot. Registration forms will NOT be accepted without payment. Registration fees are payable ONLINE ONLY. Please visit our website: https://www.ccdcrocks.com/payments to make your registration payment. Please use the “CCDC Registration Fee” section and fill in the information box completely. Registration fees are non refundable for any reason.

Classes DO have a maximum capacity and DO fill up quickly. You may be placed on a wait list. Please contact the Center Director to discuss your options if your desired class selection is full.

Please complete ONE FORM per child that you are registering.

If you are registering and paying for multiple children, please combine the total and make only one transaction.
Email address *
Parent or Guardian Name: *
Phone Number: *
Child's Full Name: *
Child's Date of Birth: *
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Today's Date:
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Please enroll my child in: *
Required
SCHOOL AGE ONLY - Please enter the name of the school your child will be attending:
SCHOOL AGE ONLY - Please enter the grade your child will be in for the 2021-2022 school year:
SCHOOL AGE ONLY - Please check *ALL* of the appropriate boxes for which you will be needing care:
SCHOOL AGE ONLY: My child is in good health and has no restrictions. Please enter parent name, child name, and date below to confirm.
A copy of your responses will be emailed to the address you provided.
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