TEMPORARY CHILD ENROLLMENT FORM



Child Development Center

 

TEMPORARY CHILD ENROLLMENT FORM

This form serves as a record stating that you have paid the Registration Fee and your child is registered to start on the date written below. The Registration Fee is non-refundable and non-transferable.

TODAY’S DATE _________________________

CHILD’S NAME __________________________________________________________ Male/Female

DATE OF BIRTH _________________________

ADDRESS ____________________________________________________________________

____________________________________________________________________

FATHER’S NAME ____________________________________________________________________

CELL PHONE __________________________ WORK PHONE __________________________

E-MAIL ADDRESS ____________________________________________________________________

MOTHER’S NAME ________________________________________________________________

CELL PHONE __________________________ WORK PHONE __________________________

E-MAIL ADDRESS ____________________________________________________________________

OFFICE FILLS OUT

START DATE __________________ ROOM # __________________

PAID: CHECK # _______ / CASH / ONLINE DATE ________ AMOUNT $ _______________

EMPLOYEE’S NAME ______________________________________

644 W. Princeton Street • Orlando, FL 32804 • • P 407-841-6020 F 407-841-6070

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download