Parent Name
Parent Email
Parent Phone
Street Address
City
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Child 1 Info
Child 1 Level: Pre-K - 2 years 9 months to 4 years by September 1K - 5 years by September 1Grade 1 - 6 years by September 1
Child 1 Date of Enrollment:
Child 1: Half or Full Day? Half Day Program 8:30-11:45Full Day Program 8:30-2:45
Child 1: Extended Hours? Before School Care 8:00-8:30After School Care 2:45-5:00
Child 2 Info
Child 2 Level: Pre-K - 2 years 9 months to 4 years by September 1K - 5 years by September 1Grade 1 - 6 years by September 1
Child 2 Date of Enrollment:
Child 2 Half or Full Day? Half Day Program 8:30-11:45Full Day Program 8:30-2:45
Child 2: Extended Hours? Before School Care 8:00-8:30After School Care 2:45-5:00
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