Parent/Guardian Name *

First Name

Last Name

Name — Child 1 *

First Name

Last Name

Attendance Days — Child 1 *

Please include the week days you are interested in sending your child.

Monday

Tuesday

Wednesday

Thursday

Friday

Name — Child 2

First Name

Last Name

Attendance Days — Child 2

Please include the week days you are interested in sending your child.

Monday

Tuesday

Wednesday

Thursday

Friday

Name — Child 3

First Name

Last Name

Attendance Days — Child 3

Please include the week days you are interested in sending your child.

Monday

Tuesday

Wednesday

Thursday

Friday