Our hours have been adjusted based on valuable feedback and community needs to better serve our families.

Enrollment Packet

Step 1 of 9

Enrollment Application

Name of Children(Required)
MM slash DD slash YYYY
Father’s Name(Required)
Marital status:(Required)
Child(ren) currently living with:(Required)
If there is an issue with releasing the child to their non- custodial parent, please provide legal documents to support the above response. We will need a copy of the court ordered custody agreement (restraining order) recognizing the parent who has legal custody of the child as well as visitation schedules; otherwise I have no choice but to release the child to the non-custodial parent.

To ensure the safety of the child, please list the other adults whom your child may be released to. Your child will only be released to the persons on this application. Any unknown person will be asked for Picture ID at pick up. We will not accept permission via text to release your child to anyone who is not listed below.