1
Step 1
Spring 21 Registration Request
Child's Name
first, last
Age
yrs
Parent's Name
first, last
Parent's Phone Number
best reachable
Parent's Email
a valid email
email
Bumblebees / Fireflies - 2-4yr olds -WAITING LIST ONLY
this group is fully booked; to be placed on a wait list,please select days interested in
Mon
Tue
Wed
Thu
Fri
Dragonflies - 5yrs and up - WAITING LIST ONLY
this group is fully booked; to be placed on a wait list,please select days interested in
Mon
Tue
Wed
Thu
Fri
Extended Hours
1pm - 3pm
Mon
Tue
Wed
Thu
Fri
Will your child be attending school or any other preschool program?
pick one!
Select An Option
Yes
No
Notes
i.e. to be on a waiting list for a specific day
0
/
Please make sure to fill out the Release & Information form next.
Submit Form
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