The Children's Corner 2023-2024 Registration Form
Child's Full Name
*
First Name
Last Name
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Age as of October 1, 2023
*
Gender:
*
Male
Female
Parent 1 Name:
*
First Name
Last Name
Parent 1 Email:
*
example@example.com
Parent 1 Phone Number:
*
Please enter a valid phone number.
Second Contact (phone number required below, can be 2nd parent or other)
*
First Name
Last Name
Second Contact Phone Number
*
Please enter a valid phone number.
Parent 2 Name:
First Name
Last Name
Parent 2 Email:
example@example.com
Days:
*
Monday - Friday (5 days)
Monday/Wednesday/Friday (3 days)
Tuesday/Thursday (2 days)
Hours Per Day:
*
Half Day (9:00am-12:30pm Infants-Early Preschool; 9:00am-1:00pm Preschool and older)
Full Day (7 hours or less - please indicate desired hours in "Notes" section below)
Extended Day (7:30am-4:30pm)
Contract Start Date:
*
Please Select
September 5, 2023
Other (please include date below)
If you selected "Other" in the question noted above (Contract Start Date), please include the desired start date in the space below:
Contract End Date:
*
June 20, 2024 (School Year Only)
August 22, 2024 (School Year + Summer Camp)
Does your child have any allergies?
*
Yes, please send Allergy Action Plan with enrollment paperwork
No
Are there any custody arrangements we should be aware of?
*
Yes, details and court documents will be provided with enrollment paperwork
No
How did you hear about us?
*
Returning Student
Family/Friend/Word of Mouth Referral
Internet Search
Drove By
Social Media (ex Facebook)
Publication Advertisement
Liberty Corner School PTO (TCC is a proud sponsor!)
Other (please feel free to indicate in the "Notes Section" below)
Notes Section: Please add any information you wish to share regarding your registration
Signature
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Submit
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