Colfax-Mingo Childcare Enrollment & Deposit Form
Use this form to reserve a spot for your child at the Colfax-Mingo Childcare Center. A non-refundable enrollment deposit is required to hold your space. Deposits are not applied toward tuition. Spots are limited and filled on a first-come, first-served basis.
Current Young Hearts clients
DO NOT COMPLETE THIS FORM.
Age Group
5 Days
4 Days
3 Days
2 Days
Babies (6weeks-24 months)
$200
$178
$156
$134
Toddler (24-36 months)
$180
$158
$136
$114
3-year-olds
$168
$146
$124
$102
4/5-year-olds
$158
$136
$114
$92
School Age (before/after)
$110
n/a
n/a
n/a
School Age (after only)
$80
n/a
n/a
n/a
Children Enrolling: Please enter your child's information below. If you are enrolling more than one child, click "Add another child".
*
Parent/Guardian Name
*
First Name
Middle Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
My Products
*
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( X )
One Child
Non-Refundable Deposit for One Child
$
50.00
Multiple Children
Non-Refundable Deposit for Multiple Children
$
100.00
Credit Card
Submit
Should be Empty: