Dear Parents,

Please take a moment and complete this form.

 I will need daycare from 7:00 A.M.

 I will need daycare from 7:30 A.M.

 I will need daycare to 5:00 P.M.

  I will need daycare to 5:45 P.M.

 I will need daycare on Fridays.

Name of Student

Birthday

Parents Name

Email

Cell Phone

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