FALL 2008

TRINITY   CHILD CARE CENTER   REGISTRATION  FORM

1556 Rex Drive ,  Orrville ,  Ohio   44667

(330) 682-1383

 

Date of Registration: _______________

Check if applicable:

_____ Parent is a Wayne College student or employee

Name of Child                                                                       Birth Date                             

Address                                                                                    Male ____ Female ____ 

                                                             Home Phone                        Cell Phone                            (city)                             (zip)                 

Name of Parents/Guardians                                          Employer                               Work Phone

(Mother)                                                                                                                                                  

(Father)                                                                                                                                                    

 

A NON-REFUNDABLE REGISTRATION FEE OF $25.00/one child or $40.00/family must accompany this application. Please make check payable to Trinity Nursery School .

 

For Office Use Only

Check# ______    Amount _______

Cash Amount _____________

 

A $20.00 supply fee will be payable by August 15, 2008.

                                                                                   

                                                                                               

                                                                                                                                               

 

I

 

I fully intend to enroll my child in the program & agree to comply with the rules and regulations of

Trinity Child Care Center to the best of my ability.

                                                                                                                                                           

                        (signature of parent or guardian)                                                     (date)

 

Child Care hours: 7:00 a.m. – 5:30 p.m., Monday – Friday

Please list child care hours needed:

_____ Monday _____________________________________

_____ Tuesday _____________________________________

_____ Wednesday __________________________________

_____ Thursday ____________________________________

_____ Friday _______________________________________

 

Wayne College Student/Faculty/Staff Rates:   Full day - $21      

  Hourly - $3.75

 

General Public Rates:                                             Full day - $24      

  Half day - $19             

                                                                                      Hourly - $4.50

  Trinity’s program is licensed by the Ohio Department of Job and Family Services