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919.247.9537
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Julia Beam – Director
Teachers
Kathy Skaarup – 2 Year Olds
Kelly Garrison – 2 & 3 Year Olds
Kerri Mamo- 4 Year Olds
Kim Boyd-3 Year Olds
Anna Shartzer – 4 Year Olds
Jessica Boes- 5 Year Olds
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3 Year Old Class
4 Year Old Class
5 Year Old Class
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Tours
New Registration Form
Parent and Child Information
Parent/Guardian First Name
(required)
Parent/Guardian Last Name
(required)
Email
(valid email required)
Confirm Email
(valid email required)
Primary Phone
(required)
Secondary Phone
Child's First Name
(required)
Child's Last Name
(required)
Sex
Male
Female
Child Date of Birth
(required)
Address
(required)
City
(required)
State
Please choose one
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
(required)
Zip
(required)
Emergency Information
Emergency Contact Name
(required)
Emergency Contact Primary Phone Number
(required)
Emergency Contact Backup Phone Number
Allergies or Intolerance to Food, Medication or other Special Needs
Child's Physician Name
(required)
Child's Physician Phone
(required)
Class Choice. Cost shown is per month.
1st Choice
Please choose one
Five day 5 year olds Mon-Fri, $515
Four day 4 year olds Mon-Thur, $415
Three day 3 year olds Mon/Wed/Fri, $315
Two day 3 year olds Tues & Thur, $215
Two day 2 year olds Mon & Wed, $215
Two day 2 year olds Tues & Thur, $215
(required)
2nd Choice
Optional
Five day 5 year olds Mon-Fri, $515
Four day 4 year olds Mon-Thur, $415
Three day 3 year olds Mon/Wed/Fri, $315
Two day 3 year olds Tues & Thur, $215
Two day 2 year olds Mon & Wed, $215
Two day 2 year olds Tues & Thur, $215
If your 1st choice is full, we will automatically register your child for your 2nd choice and add you to the waiting list for the 1st choice.
Electronic Signature
Electronically sign by typing first and last name
(required)
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