Interested in signing up your child for EduCare?

Please complete the form below

Parent's Name

First Name

Last Name

Email Address

Phone

(###)

###

####

Child's Name

If more than one child, you will need to complete a new form for each child.

First Name

Last Name

Child's DOB

Date of Birth

MM

DD

YYYY

PT or FT care?

Part-Time or Full-Time Care

Part-Time

Full-Time

When do you need care?