APPLICATION

Child's Full Name *

First Name

Last Name

First Name Child Prefers

For example list any nicknames.

First Name

Last Name

Child's birthdate *

MM

DD

YYYY

When would your child be starting at Puddletown *

2025-206

2026-2027

2027-2028

2028-2029

What program(s) and schedule would you like for your child? Check all that apply: *

Preschool-Kindergarten 8:20am-1:00pm (half day, 3-6 year olds, 5 days/week)

Preschool-Kindergarten 8:20am-3:00pm (full day, 3-6 year olds, 5 days/week)

Elementary/1-6th Grade 8:20am-3:10pm (6-12 year olds, 5 days/week)

Middle School/7-8th grade 8:45-3:30pm (12-15 year olds, 5 days/week)

Before Care 7:30am - 8:20am (all ages, offered 5 days a week)

After Care 3:20pm - 5:30pm (all ages, offered 5 days a week)

Phone *

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