Child's First Name - "Undecided" is OK (required):
Child's Last Name (required):
Child's Date Of Birth (optional):
Or Expected D.O.B. (optional):
Please leave this field empty.
Program Needed (required):
InfantToddlerPreschoolKindergartenSchool Age
Infants: 0-18 Mos | Toddlers 18 Mos - 2.5 Yrs | Preschool 2.5 - 3.8 Yrs | Kindergarten 3.8 - 5 Yrs | School Age 6 - 12 Yrs
Date Of Required Care (required):
Subsidy Or Transfer Applied For? (required)
YesNo
McMurrich Sprouts Daycare places preference on siblings of children already enrolled in our program (or who are on the waiting list). If applicable, please enter the sibling's name and date of birth below:
Sibling Name (optional):
Sibling Birth Date (optional):
Please add the contact information for at least one parent or legal guardian (a second parent's or legal guardian's information is optional):
First Name (required):
Last Name (required):
Address (required):
Email (required):
Mobile Telephone (required):
Work Telephone (optional):
First Name (optional):
Last Name (optional):
Address (optional):
Email (optional):
Mobile Telephone (optional):
Subject (required):
Add extra comments here (required):
IMPORTANT: Please review your selections for accuracy before clicking the button below.
Please also note that any information you submit is secure and won't be sold, shared or traded with any third parties.