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SAFETY FIRST We're taking extra measures to ensure your children are safe in our nursery.

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Admissions

Pre-Enrollment Registration

Name & Ages of Child(ren)

What shift do you require? (What are your work hours)

Do you have any kids with special needs? (Please describe)

Does your child require an medications? (Please describe)

Does your child have any alergies?

Does your family have any religious beliefs? (Please descibe)

Add answer here

Has your child attended daycare before? * Required

Yes

No

Please list any questions you have regarding your childcare experience.

How will you pay fees? * Required

WI Shares

Private Pay

Your Fullname

Phone

Anticipated Start Date

Who referred you?

What time of day are you available for tour?

Thank you! We’ll be in touch.

1 John 2:28 "And now, little children, abide in him: that, when he shall appear, we may have confidence, and not be ashamed before him at his coming"

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