Zion Day Care Schedule Registration Form

Please complete the information below to register for Day Care.

Parent Name: Parent Name: First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Is your Daycare covered by DHS?
1.Student Name: 1.Student Name: First Last
Age of Child

Age of Child Infant Toddler (1 - 2 yrs) Preschool (3 yrs) School Age (5 yrs and older)
2.Student Name: 2.Student Name: First Last
Age of Child

Age of Child Infant Toddler (1 - 2 yrs) Preschool (3 yrs) School Age (5 yrs and older)
3.Student Name: 3.Student Name: First Last
Age of Child

Age of Child Infant Toddler (1 - 2 yrs) Preschool (3 yrs) School Age (5 yrs and older)
Contact Email:
Which room will your child attend care for?

Which room will your child attend care for? Infant/Guppy Room (0 - 1 yrs) Miss Cearra Toddler/Explorer Room (1 yr - 2 yrs) Mrs. Cindy Preschool/Wilderness Critters Room (2ys - 3yrs) Miss Madison Before/After School 3:00 - 5:30 pm

Please fill in by your preference, by week, or two weeks or monthly. Schedules are due on the Wednesday before care is needed:
Note: Childcare will be closed on Friday, February 13, due to staff training. Child care will be open on Monday, February 16 for Infants - 4 year olds.
It is not available for K-8.
	Monday	Tuesday	Wednesday	Thursday	Friday
Week of April 6	Week of April 6Monday	Week of April 6Tuesday	Week of April 6Wednesday	Week of April 6Thursday	Week of April 6Friday
Week of April 13	Week of April 13Monday	Week of April 13Tuesday	Week of April 13Wednesday	Week of April 13Thursday	Week of April 13Friday
Week of April 20	Week of April 20Monday	Week of April 20Tuesday	Week of April 20Wednesday	Week of April 20Thursday	Week of April 20Friday
Week of April 27	Week of April 27Monday	Week of April 27Tuesday	Week of April 27Wednesday	Week of April 27Thursday	Week of April 27Friday
May 4	May 4Monday	May 4Tuesday	May 4Wednesday	May 4Thursday	May 4Friday
May 18	May 18Monday	May 18Tuesday	May 18Wednesday	May 18Thursday	May 18Friday
May 25	May 25Monday	May 25Tuesday	May 25Wednesday	May 25Thursday	May 25Friday
June 1	June 1Monday	June 1Tuesday	June 1Wednesday	June 1Thursday	June 1Friday
June 8	June 8Monday	June 8Tuesday	June 8Wednesday	June 8Thursday	June 8Friday
June 15	June 15Monday	June 15Tuesday	June 15Wednesday	June 15Thursday	June 15Friday
June 22	June 22Monday	June 22Tuesday	June 22Wednesday	June 22Thursday	June 22Friday
June 29	June 29Monday	June 29Tuesday	June 29Wednesday	June 29Thursday	June 29Friday

Drop Off Time:
Pick Up Time
Drop off/Pick up times if different than above:
Include the week/day/drop off and pick up time.
Zion Child Care Rates

Infant – Toddler ($8.00 per hour)

3 – 4 Years ($7.00 per hour)
After School Care

Grades Preschool - 8th Grade
Before School Child Care $10 per day per child
After School Child Care $15 per day per child
Before and After School Child Care $20 per day per child
Summer Program Registration
$50 per day / per child
Online registration form with payments are going through FACTS and will be billed after each week.
Spam Protection. Please answer this simple question:
If yesterday was Friday what day is today?