Instructions

  1. Fill out this form online
  2. Print it and mail it in

Crayons Registration Application
Name of Child: Date of Application:
Address:
City: State:
Zip: Telephone:
 
Name of Mother:  
Address:
City: State:
Zip: Telephone:
 
Name of Father:  
Address:
City: State:
Zip: Telephone:
 
 
Persons To Contact Other Than Parent In An Emergency:
 
Name:  Telephone:  
Address:
City: State:
Zip: Telephone:
 
 
Name:  Telephone:  
Address:
City: State:
Zip: Telephone:
 
 
Recommended by:
 
Day of Attendance Requested:  M   T   W   TH   F   
Please Indicate Full or Half Days: Full Half  
I will Bring My Child to School At About: AM FM  
I will Pick My Child Up At About: AM FM  
 
 
Placement:  
 
A Registration Fee of $35 Must Accompany This Application.
 
  Make Check Payable to: "Crayons Child Care" 
  Paid: $  
 
  Signed:

______________________________________ 		    
  Parent or Guardian Signature    
 
 
Start Date:   End Date:    
To Print: Click here or Select File/Print from your Browser Menu.

Mail to:

Crayons Child Care & Family Services Inc.
3445 Post Road, Warwick, RI. 02886

 

Close this window

3445 Post Road Warwick, RI 02886
Copyright ©  · Kent County Arc · J. Arthur Trudeau Memorial Center  ·  All Rights Reserved