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Next Steps Fast Track Childcare Registration

Please register by June 16 for session 1, and July 14 for session 2.

Parent or Guardian Name *
Parent or Guardian Name
Phone *
Phone
Child #1 Name *
Child #1 Name
Child #1 Date of Birth *
Child #1 Date of Birth
Child #1 Gender *
Child #2 Name
Child #2 Name
Leave blank if only registering one child. If registering more than 3 children, please submit an additional form for the remaining children.
Child #2 Date of Birth
Child #2 Date of Birth
Child #2 Gender
Child #3 Name
Child #3 Name
Child #3 Date of Birth
Child #3 Date of Birth
Child #3 Gender