Waiting List Form 2018 1

Covenant Presbyterian Children’s Center ~Waiting List Form Completion of this form and paying $25 does not guarantee that a space will be available for your child by the date specified. Having your requested enrollment date helps us understand your needs. We strongly suggest parents have a back-up plan for childcare in the event a spot is not available by the requested enrollment date. If a vacancy becomes available prior to your requested enrollment date and your child is next on the list, you will be given an opportunity to accept or decline this early enrollment opportunity. You will be given 24 hours to accept or decline a spot once contacted.

*Please print clearly

*A $25 waiting list fee must be submitted with this form

Requested Enrollment Date ___________________________________________________________________ Child’s Name (first & last or unknown & last) __________________________________________________ Birthday/Due date (mm/dd/yy) _________________________________________Circle One: Boy

Girl

Parent’s Name (first & last) _____________________________________________________________________ Address______________________________________________ City, State, Zip___________________________ Telephone (cell/work/home) ____________________________________________________________________

Email address: _________________________________________________________________________________ Sibling at CPCC, Name ___________________________________________ Class: _______________________ If previous Preschool/Daycare Experience, Where? ______________________________________________ It is the parent’s responsibility to call and update the above information

***********************OFFICE USE BELOW THIS LINE*********************** Date Received ____________________ Check # ____________________ Amount ____________________ Child/Group: __________________________________________________________________________________ Notes: