Zion Day Care Schedule Registration Form

Please complete the information below to register for Day Care.

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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 Toddler (1 - 3 yrs) Preschool (3 - 4 yrs) School Age (5 yrs and older)
2.Student Name: 2.Student Name: First Last
Age of Child

Age of Child Toddler (1 - 3 yrs) Preschool (3 - 4 yrs) School Age (5 yrs and older)
3.Student Name: 3.Student Name: First Last
Age of Child

Age of Child Toddler (1 - 3yrs) Preschool (3 - 4 yrs) School Age (5 yrs and older)
Contact Email:
Which room will your child attend for care?
Which room will your child attend care for?

Which room will your child attend care for? Toddler/Guppy Room (1yr - 3 yrs) Miss Claire Preschool/Wilderness Critters Room (3ys - 5yrs) Miss Jasmine After School (P4 - 12yrs) Summer Program (5 yrs and older) Miss Baylie

Please fill in by your preference, by week, or two weeks or monthly. Schedules are due on the Wednesday before care is needed:
	Monday	Tuesday	Wednesday	Thursday	Friday
Week of October 16	Week of October 16Monday	Week of October 16Tuesday	Week of October 16Wednesday	Week of October 16Thursday	Week of October 16Friday
Week of October 23	Week of October 23Monday	Week of October 23Tuesday	Week of October 23Wednesday	Week of October 23Thursday	Week of October 23Friday
Week of October 30	Week of October 30Monday	Week of October 30Tuesday	Week of October 30Wednesday	Week of October 30Thursday	Week of October 30Friday
Week of November 6	Week of November 6Monday	Week of November 6Tuesday	Week of November 6Wednesday	Week of November 6Thursday	Week of November 6Friday
Week of November 13	Week of November 13Monday	Week of November 13Tuesday	Week of November 13Wednesday	Week of November 13Thursday	Week of November 13Friday
Week of November 20	Week of November 20Monday	Week of November 20Tuesday	Week of November 20Wednesday	Week of November 20Thursday	Week of November 20Friday
Week of November 27	Week of November 27Monday	Week of November 27Tuesday	Week of November 27Wednesday	Week of November 27Thursday	Week of November 27Friday
Week of December 4	Week of December 4Monday	Week of December 4Tuesday	Week of December 4Wednesday	Week of December 4Thursday	Week of December 4Friday
Week of December 11	Week of December 11Monday	Week of December 11Tuesday	Week of December 11Wednesday	Week of December 11Thursday	Week of December 11Friday
Week of December 18	Week of December 18Monday	Week of December 18Tuesday	Week of December 18Wednesday	Week of December 18Thursday	Week of December 18Friday
Week of December 25	Week of December 25Monday	Week of December 25Tuesday	Week of December 25Wednesday	Week of December 25Thursday	Week of December 25Friday
Week of January 1	Week of January 1Monday	Week of January 1Tuesday	Week of January 1Wednesday	Week of January 1Thursday	Week of January 1Friday
Week of January 8	Week of January 8Monday	Week of January 8Tuesday	Week of January 8Wednesday	Week of January 8Thursday	Week of January 8Friday
Week of January 15	Week of January 15Monday	Week of January 15Tuesday	Week of January 15Wednesday	Week of January 15Thursday	Week of January 15Friday

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

Please select the number of days your child will be attending Zion.
Child Care Rate
1 Year - 3 Years ($48.00 per day)
Child Care Rate
3 Years - 5 Years ($40per day)
Snow Days/Summer Rate
Ages 5 & Up per Week
Family Rate with 2 Kids (Excludes Infants and Toddlers):
Family Rate with 3 Kids (Excludes Infants and Toddlers):
After School Care

Grades Preschool - 8th Grade
Pre 3 Half day after school:
Mondays, Wednesdays & Fridays ($35)
After School Child Care $13
Summer Program Registration
$30 per day / per child
1 Child
2 Children
3 Children
Online registration form that payments are going through FACTS and will be billed after each week.
Spam Protection. Please answer this simple question:
If tomorrow is Friday what day is today?
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Zion Day Care Schedule Registration Form

Zion Day Care Schedule Registration Form

$`0`

Total

Zion Child Care Rates

After School Care

Summer Program Registration
$30 per day / per child

Online registration form that payments are going through FACTS and will be billed after each week.

$`0`

Total

Zion Day Care Schedule Registration Form

Zion Day Care Schedule Registration Form

$0

Total

Zion Child Care Rates

After School Care

Summer Program Registration $30 per day / per child

Online registration form that payments are going through FACTS and will be billed after each week.

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Total

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Summer Program Registration
$30 per day / per child

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