Early Arrival Registration Form

Please complete the form below. Required fields marked *

For more than 2 children, please scroll to the end of the form to add additional children.

Parent name*

Answer required for "Parent name"

I understand that all Early Arrival charges will be posted to my FACTS account*

Answer required for "I understand that all Early Arrival charges will be posted to my FACTS account"

Yes

I would like to pay for the full year in advance at $1,000 per child?

Answer required for "I would like to pay for the full year in advance at $1,000 per child?"

Yes

Comments

How often do you expect to use Early Care?

Answer required for "Comments"

Child 1: Name*

Answer required for "Child 1: Name"

Child 1: Grade and Homeroom Teacher*

Answer required for "Child 1: Grade and Homeroom Teacher"

Child 1: Allergies*

Answer required for "Child 1: Allergies"

Days Expected to Use Early Arrival (check all that apply)

Answer required for "Days Expected to Use Early Arrival (check all that apply)"

Monday

Tuesday

Wednesday

Thursday

Friday

Child 2: Name

Answer required for "Child 2: Name"

Child 2: Grade and Homeroom Teacher

Answer required for "Child 2: Grade and Homeroom Teacher"

Child 2: Allergies

Answer required for "Child 2: Allergies"

Days Expected to Use Early Arrival (check all that apply)*

Answer required for "Days Expected to Use Early Arrival (check all that apply)"

Monday

Tuesday

Wednesday

Thursday

Friday

Parent's Contact Information (Name, Email Address, Phone Number)*

Answer required for "Parent's Contact Information (Name, Email Address, Phone Number)"

Emergency Contact Information (Name, Relationship to Child, Email Address, Phone Number)

Answer required for "Emergency Contact Information (Name, Relationship to Child, Email Address, Phone Number)"

Child 3: Name

Answer required for "Child 3: Name"

Child 3: Grade and Homeroom Teacher

Answer required for "Child 3: Grade and Homeroom Teacher"

Child 3: Allergies

Answer required for "Child 3: Allergies"

Days Expected to Use Early Arrival (check all that apply)

Answer required for "Days Expected to Use Early Arrival (check all that apply)"

Monday

Tuesday

Wednesday

Thursday

Friday

Please fix the highlighted areas below before submitting.

Early Arrival Registration Form