CHILD CARE AND PRESCHOOL

Helping your child learn and grow through trusted child care services and progressive early childhood education.

Thank you for your interest in early education and child care at Rainbows United, Kids’ Point, 3223 North Oliver Avenue.

The following information will be helpful in understanding your child care needs. Please complete this form along with a payment. Upon receipt of this request and as soon as an opening becomes available, our Admissions Department will contact you. Thanks again and we look forward to hearing from you!

Request for Early Education and Child Care

Step 1 of 3

Child #1

Child's Name

First Last

Date of Birth

Desired Start Date

Child #2

Child's Name

First Last

Date of Birth

Desired Start Date

Do you have more than 2 children you need to request care for?(Required)

Yes, 1 more

Yes, 2 more

Child #3

Child's Name

First Last

Date of Birth

Desired Start Date

Child #4

Child's Name

First Last

Date of Birth

Desired Start Date

Schedule

Hours you will be needing child care services. Kids' Point is open from 7 a.m. until 5:45 p.m. Monday through Friday.

Arrival Time(Required)

Departure Time(Required)

Parent Information

Mother's Name

First Last

Cell Phone

Work Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employer Name

Father's Name

First Last

Cell Phone

Work Phone

Father's Address different than Mother's?

Yes

Father's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employer Name

CHILD CARE AND PRESCHOOL

Helping your child learn and grow through trusted child care services and progressive early childhood education.

Request for Early Education and Child Care

Child #1

Child #2

Child #3

Child #4

Schedule

Parent Information

Non-refundable Deposit

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