REGISTRATION FORM

REGISTRATION FEE IS NON REFUNDABLE. REGISTRATION FEE: $150 PER CHILD OR $225 FOR MULITPLE CHILDREN.

PLEASE COMPLETE THE REGISTRATION FORM & MAKE REGISTRATION FEE PAYMENT ONCE THE REGISTRATION FEE IS PAID (Credit card or Cash only)

THEN YOU WILL RECEIVE ACCESS TO COMPLETE THE ENROLLMENT PAPERWORK

Welcome to Precious Lambs, Inc. Early Childhood & Child Care Center! We are delighted that you and your child would like to join our program. This information is considered confidential and will be shared ONLY as required by law

CHILD 1 INFORMATION

First child Name *

First child Age *

First child Date of Birth *//

First child Gender *

Male
Female

First child Home Address *

Address Line 1

City

State

Zip Code

CHILD 2 INFORMATION

Second Child Name *

Second Child Age *

Second Child Date of Birth *//

Second Child Gender *

Male
Female

Second Child Home Address *

Address Line 1

City

State

Zip Code

ENTER THE HOURS NEEDED FOR CARE EACH DAY

Requested Start Date *

Monday

Tuesday

Wednesday

Thursday

Friday

PARENT /GUARDIAN WHO IS REGISTERING CHILD

Name *

Date of Birth *//

Home Address *

Address Line 1

City

State

Zip Code

Home Phone *

Cell Phone

Work Phone

Email *

Signature *

Checkboxes

I understand that the registration fee is NOT refundable.

Name

REGISTRATION FORM

CHILD 1 INFORMATION

CHILD 2 INFORMATION

ENTER THE HOURS NEEDED FOR CARE EACH DAY

PARENT /GUARDIAN WHO IS REGISTERING CHILD

Have Questions?

BRANFORD – 203-488-5437

CHESHIRE – 203-271-1147

WALLINGFORD – 203-269-5437