Daycare Detailed Registration Form

Little Tot’s Learning Daycare, II

Loving and qualified care for your little one, flexible hours, etc..
Enroll Today and Receive 10% Off Your Child’s First Week of Care!

Recent Testimonial: "Little Tot’s Daycare took amazing care of my boys! They still talk about Ms. Torra’s daycare. The activities and hands-on crafts were beyond anything I expected.” — Christal G.
Section#1

Parent/ Guardian Information
Parent's Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Zip Code*
Type of Service Needed:*

Full-TimePart-TimeBefore & After SchoolSaturdayTransportation (Enrolled Children Only)Overnight Care
Section#2

Child's Information
Child's Name

First NameLast Name
Child's D.O.B*

MonthDayYear
Date
Do you have more than 2 children enrolling?

YesNo
If yes, list child's D.O.B.

MonthDayYear
Date
Perferred Start Date:*

MonthDayYear
Date
Acknowledgment of Registration & Discount Terms:*

Yes, I understand the $90 non-refundable registration fee is required to secure my child’s spot. I also understand that the first full week of childcare must be paid in advance, and that the 10% Special discount will be applied only after the first full week’s payment and all required enrollment documents are received. I understand that enrollment is not complete and care will not begin until all required fees and documents are received.

My Products

Registration FeeThis non-refundable fee secures enrollment and qualifies your family for 10% off after the first full week of care when paid.

$90.00 Quantity

Total

$0.00

What Happens Next: Once your registration fee has been received our team will contact you to guide you through the remaining enrollment steps.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
Date
Signature
Should be Empty:

Little Tot’s Learning Daycare, II