A $100 non-refundable / non-transferable registration fee (per child) is required upon submission.
Please select the number of children being registered for the Olivia Haverkamp Early Learning Center.
Please provide any additional information about this child that may be relevant to their participation in childcare.
Registration Options — Child One
Please provide any additional information about this child that may be relevant to their participation in childcare.
Registration Options — Child Two
Please provide any additional information about this child that may be relevant to their participation in childcare.
Registration Options — Child Three
Primary Home Address for Child(ren)
Parent/Guardian Information
Please select the number of parent(s)/guardians(s) for the student(s) being registered.
Parent/Guardian Responsibility
Please check ALL that apply.
Parent/Guardian Responsibility
Please check ALL that apply.
Does your child(ren) have additional siblings not previously listed on this form?