The
Children’s Center, Inc.
Registration Form
Child's Name:__________________________ Child's Birth Date:
______________
Parent's Name(s)______________________________ Phone Number:
___________
Address
______________________________________________________________
Beginning Date of Attendance: ____________________Time
Clock:___________
(Choose
4-digit code)
___ Summer Session ($15.00 Registration Fee)
__ Fall Session ($25.00 Registration Fee)
__ Infant/Toddler (6 weeks to 30 months)
__ Preschool (2 1/2 to 5 years) __ School-Age
(k-6th grades)
(if school-age note
school attending _______________________)
Registration Fee Must Accompany
Registration To Hold Spot /
non-refundable
Please note times reserving below
|
Monday
|
Tuesday
|
Wednesday
|
Thursday
|
Friday
|
|
In:
Out
|
In:
Out
|
In:
Out
|
In:
Out
|
In:
Out
|
Weekly Child Care Rates
Infant/Toddler Rate: full time only $160.00 per
week
Full Time
(over 30 hours per week) $125.00 per week Part
time (under 30 hours per week) $80.00 per week
School-Age:
1st - 6th grade before and after school (7-9
am and 3-6 pm)........$65.00
Pre-School Only - Monthly Rates
__ 2's and 3's preschool (must be 2 1/2 by
first day of school - minimum of 2 days per week) $80.00 per month
__ 3's and 4's preschool (must be 3
1/2 by first day of school - minimum of 3 days per week) $90.00 per month
__ Pre-k class (must be 4 1/2
by first day of school - all 5 days) $110.00 per month
All preschool
days are from 9:00 a.m.
to 11:30 a.m.
Parent Signature: ________________________________
Date: __________________________