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Registration Form

Child #1, First & Last Name*

Date of birth*

MaleFemale

Child #2, First & Last Name

Date of birth

MaleFemale

Morning Drop Off Time *

Morning drop off is strictly between the hours of 7am and 8:30am. Families must drop off at their specified time only. Please choose a specific time (7:10, 7:15, 7:20 etc.)

Pick Up Time*

Pick up is between 3:45pm - 4:45pm only. Please select your pick up time below.

Parent/Guardian, #1 First & Last Name*

Relationship to Child*

Best number to reach:*

Email address*

Street Address*

Town*

Zip Code*

Parent/Guardian #2, First & Last Name

Relationship to Child

Notes/comments:

To complete this transaction, please submit your registration fee through VENMO @rockthebaby Thank you for registering!

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Thank you! We will be in touch ASAP with a quote for care