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Program *

Infant 6M-12M (Part Time)

Infant 6M-12M (Full Time)

Infant 12M-17M

Toddler 18M - 3Y

Nursery School 3YRS - 5YRS

Extended Day Program

Early Bird Drop-Off (7:30 am - 8:30 am) - $200/ month

Aftercare Enrichment Classes (3:30 pm - 5:00 pm) - 350/ month

I don't need the Extended Day Program

Child's Name *

First Name

Last Name

Female

Male

Birthdate *

MM

DD

YYYY

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Household Phone *

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Parent/Guardian 1 *

First Name

Last Name

Mobile Phone *

(###)

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Parent/Guardian 2 *

First Name

Last Name

Mobile Phone *

(###)

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Child's full name *

First Name

Last Name