Online Registration & Rates

Request for Child Care Please note: Your child will not be automatically enrolled into care by completing this form, however,  you will be guaranteed next in line on our waiting list. Circumstances, such as space, hours, age and availibility will have to be reviewed before placement can be considered.  A parent/provider interview,  formal contract application and a tuition deposit is required for all new children entering into care.
First name:	* required
Last name:	* required
Child's Name:
Child's Age:	* required
Gender:
Email address:
Home Phone:	* required
Mailing address:
Days and Hours Requested
Hours Requested:	Monday Tuesday Wednesday Thursday Friday
Best Way to Contact You	Email address Mailing address Phone

Number of Days	Part Time Weekly Rate (1-4 Hours per day)	Full Time Weekly Rate (4-8 Hours Daily)	Extended Weekly Rate (8-10 Hours per day)
1	$25.00	$50.00	$60.00
2	$50.00	$100.00	$120.00
3	$75.00	$135.00	$160.00
4	$100.00	$180.00	$200.00
5	$125.00	$225.00	$250.00