2019 / 2020 Playcare Registration form

Click Link below for PDF printable copy

http://wesleyumc-dover.com/wp-content/uploads/2019/01/2019-2020-PC-Registration-003.pdf

2019-2020

Wesley United Methodist Church

209 S. State Street, Dover, DE 19901 – 678-8987

Wesley Play Care Registration Form

Registration Fee $50.00 – This fee is waived for children registered in Preschool.

Start Date:___________________________

Please print clearly!

Please list and be specific with days and times needed:

Days Needed:____________________________________Times:___________________

____My child is a napper    ____My child is a non-napper

Child’s Name_______________________________________M_________F______________________

Nickname_____________________________Birth Date___________________Age_________________

Address_______________________________________________________________________________

Home Phone__________________________________  Cell Phone_______________________________

Email______________________________________________________

Mother’s Name____________________________________Work Phone__________________________

Father’s Name____________________________________ Work Phone__________________________

Legal Guardian____________________________________Work Phone__________________________

Emergency Contact_________________________________Phone_______________________________

Preschool Class, if registered________________________________Days & Times__________________

Note:  Preschool registration must take place on a separate form.  Please remember to notify the Preschool Office immediately if your original Play Care times change.