Parent/ Guardians Name
Childs Birthdate: (ex.11/21/2012)
Days will attend each week: (either Tuesday, Wednesday, Thursday or multiple days.)
3-day a week 1 month (Add $150.00)
2-day a week 1 month (Add $115.00)
For your convenience you can set up an automatic monthly payment in our online system. Just click in the online giving section of our webpage and it will walk you through.
Your Email Address
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