* Required

Child(ren) Information

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.​​​​

Child One

Please provide any additional information about this child that may be relevant to their participation in childcare.​

Registration Options — Child One

Please select the preferred days this child will be attending the Olivia Haverkamp Early Learning Center​​.​​​​

Child Two

Please provide any additional information about this child that may be relevant to their participation in childcare.​

Registration Options — Child Two

Please select the preferred days this child will be attending the Olivia Haverkamp Early Learning Center​​.​​​​

Child Three

Please provide any additional information about this child that may be relevant to their participation in childcare.​

Registration Options — Child Three

Please select the preferred days this child will be attending the Olivia Haverkamp Early Learning Center​​.​​​​

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 One

Parent/Guardian Responsibility

Please check ALL that apply.

Parent/Guardian Two

Parent/Guardian Responsibility

Please check ALL that apply.


Sibling Information

Does your child(ren) have additional siblings not previously listed on this form?​​​​​​
Is this child a current GRCS student?​​​​
Is this child a current GRCS student?​​​​​
Is this child a current GRCS student?​​​​​
Is this child a current GRCS student?​​​​
Is this child a current GRCS student?​​

Other