Space is limited in all age groups, so please take the time to pre-register your child using this on-line form. Pre-registration is not a commitment to attend or a promise of acceptance.

Because enrollment is based on a first-come first-served basis, pre-registering will assist you in reserving a place for your child in their respective age group. Once your pre-registration has been submitted, you will be contacted regarding availability.

Parent Information   *Required Fields First Name * MI Last Name * Additional Parent Information (Spouse/Significant Other) First Name MI Last Name Residence Street Address * City * State * Zip * Contact Information Home Phone * Work Phone Cell Phone E-mail * E-mail (Secondary) Child’s Information First Name * MI Last Name * Child’s Gender Child’s Birthdate * Select Gender Male Female Select Month January February March April May June July August September October November December Select Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select Year 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Enrollment Type * Desired Start Date * Select One Full Time Part Time Before School Only After School Only Before & After School Select Month January February March April May June July August September October November December Select Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select Year 2006 2007 2008 2009 2010 Second Child’s Information First Name MI Last Name Child’s Gender Child’s Birthdate Select Gender Male Female Select Month January February March April May June July August September October November December Select Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select Year 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Enrollment Type Desired Start Date Select One Full Time Part Time Before School Only After School Only Before & After School Select Month January February March April May June July August September October November December Select Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select Year 2006 2007 2008 2009 2010

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