Kindergarten Afternoon Arrangement Form
Please complete this form to arrange your child's afternoon care at our kindergarten.
Child's Full Name
*
First Name
Last Name
Child's Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Days Required for Afternoon Care
*
Monday
Tuesday
Wednesday
Thursday
Friday
Authorized Person(s) for Pickup (Name & Relationship)
*
Please list any allergies, medical conditions, or special instructions
Submit Arrangement
Should be Empty: