Waitlist Confirmation
School Skills Waitlist (3-5 year-olds)
Parent Name
*
Email Address
*
Phone Number
*
Child's Name
*
Child's Birthdate
*
Preferred day(s) of the week
*
Mondays 10:30a-12:30p
Tuesdays 11:15a - 1:15p
Wednesdays 11:15a-1:15p
Fridays 10a-12p
Is your child potty trained?
*
Fully restroom independent
Needs some assistance
In progress
Not yet
Please disclose any special needs, whether or not diagnosed, and other important information concerning the child(ren) named above that will enable Gymboree Learning Center to be better equipped to attend to said child(ren). Special needs include attention or communication difficulties, behavioral and/or physical issues, etc. Important information includes, but is not limited to, allergies, health problems, etc. Gymboree Learning Center cannot take responsibility for administering any medication.
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