Childcare Booking Form

Childcare Booking Form

Please fill out your details to book a drop-in childcare session.
Parent/Guardian Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Child's Full Name

First NameLast Name
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Special Instructions or Allergies
What care do you need?
Drop off time and pick off time

Hour Minutes

AM/PM Option

Until

Hour Minutes

AM/PM Option
Total 0.0
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

SERVICE FEE

Weekly Tuition

Infant Care (0–17 Months)

Monday–Friday

$295.00 Quantity

Weekly Tuition

Toddler Care (18–35 Months) Monday–Friday

$290.00 Quantity

Weekly Tuition

Preschool (3–5 Years)

Monday–Friday

$285.00 Quantity

Weekly Tuition

School-Age Summer Care

Monday–Friday

$275.00 Quantity

Part-Time – 2 Days

Any 2 days

$150.00 Quantity

Part-Time – 3 Days

Any 3 days

$195.00 Quantity

Part-Time – 4 Days

Any 4 days

$245.00 Quantity

Before School Care

PER WEEK

$125.00 Quantity

After School Care

PER WEEK

$130.00 Quantity

Before & After School Care

PER WEEK

$255.00 Quantity

School Transportation

PER WEEK

$100.00 Quantity

Overnight Care

6:00 PM–6:00 AM

$95.00 Quantity

Saturday Care

Up to 10 hours

$80.00 Quantity

Full-Day Drop-In

Up to 10 hours

$65.00 Quantity

Half-Day Drop-In

Up to 5 hours

$35.00 Quantity

Total

Payment Methods

Credit Card

Apple Pay

Cash App Pay

ACH Bank Transfer

Should be Empty:

Childcare Booking Form

SERVICE FEE*

Payment Methods

SERVICE FEE