436 Port Reading Ave, Port Reading NJ 07064 |
(732) 634-1403
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Monthly Registration
Monthly Registration Form
Must fill out a form for each child if you are registering more than one child.
Childs Name
First Name*
Last Name*
Parent Name
First Name*
Last Name*
E-mail
Required*
Phone
Required*
-
-
School
Please provide school your child attends*
Grade
Required*
Select Month or Break you are registering for
Required*
Please make a selection
September
October
November
December
January
February
March
April
May
June
Summer Break
Which type of care
Required*
Before Care
Aftercare
Full Day Care
Fall Break
Spring Break
Please input the days you need for the month you are registering for
Required*
You can write like this: 2/1, 4, 6, 8, or All Days or Week of ?. You can also do Before Care 2/1, 2, 3.... Aftercare 2/1,5, 6, 7.... Full Day 2/8, 9, ...
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Important
PAYMENT MUST BE IN FULL by the 1st of the month. Please make a copy of your registration form. Your canceled check is your receipt. We will do payment arrangements on a case by case basis. Receive a 10% discount on your total if paid in full by the 21st of the month.
It may take a moment for your information to be submitted.
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