2019-20 CC Inquiry Form

YMCA OF MOUNT VERNON CHILD CARE INQUIRY FORM
WE CURRENTLY HAVE A WAIT LIST. AS SOON AS A SPOT OPENS FOR YOUR CHILD, YOU WILL RECIEVE A PHONE CALL. UNTIL THEN, WE WILL BE HAPPY TO ADD YOU TO THE WAITLIST.
Parent/Guardian Name *

First Name Last Name
E-mail *
Contact Number *

Attendance: tick the days you would like your child to attend and write the times.

Drop Off Time

Pick Up Time

Monday

Tuesday

Wednesday

Thursday

Friday