Chai Tots Preschool
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Step
1
of
3
33%
Child's First Name
*
Last Name
*
Hebrew Name
Nickname
Birth Date
*
MM slash DD slash YYYY
Gender
Address
Street Address
Mother's Name
*
Jewish
*
YES
NO
Address
*
Street Address
Mother's E-mail
*
Mother's Cell Phone
*
Mother's Work Phone
Mother's Occupation and Place of Employment
*
Father's Name
*
Jewish
*
Yes
No
Address
Street Address
Father's E-mail
*
Father's Cell Phone
*
Father's Work Phone
Father's Occupation and Place of Employment
*
I am interested in:
3 half days
3 full days
5 half days
5 full days
I need Early/Aftercare Care (Additional $15 per hour, per child)
Early care (at 8 AM)
fter care (until 4 PM)
Days of the week you prefer (if Applicable): ***Please note that there are no guarantees for day preferences. We will do our best to accommodate you.
Are there any medical problems that we should be aware of?
I reviewed the guidelines and regulations and I hereby register my child for the Chai Tots Day Camp Summer of 2024. Registration fee and Day Camp Tuition are non refundable.
I reviewed the guidelines and regulations and I hereby register my child for the Chai Tots Day Camp Summer of 2024. Registration fee and Day Camp Tuition are non refundable.
Electronic Signature of Parent
*
There will be a non refundable $100 fee for registration which must be paid upon form submission.
Price:
Total
$ 0.00
Credit Card
Card Details
Cardholder Name
