Child Care Registration Form

Child Care Registration

Waitlist
Information of Child
Name

First NameLast Name
Birth Date

MonthDayYear
Date
School

SaugatuckHurlbuttLong LotsWISGreens FarmColeytownKings HighwayOther School District
Grade Level

Kindergarten1st2nd3rd4th5th
Days of the week after care needed:

MondayTuesdayWednesdayThursdayFriday
Information of Parent
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.
Email Address
example@example.com
Should be Empty:

Child Care Registration