Registration

Interested in having your child join the Peppermint Tree community? Please complete this secure form and you’re on your way!

Child's Information

* denotes "required" field


Home Address

Parents' Information

Parent/Guardian

Parent/Guardian 2

Physician/Emergency Contact:

Physician


Emergency Contact

Who is authorized to pick up your child?

Other Children in Family:

Are you registering your child for:

Child's Calendar




* Saturday morning music and movement

Weekly Schedule

From: To: # of Hours:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday*

* Saturday is restricted to “My Parent and Me” ONLY!

How did you hear about The Peppermint Tree?


After you submit this form, you'll have the option to pay the Registration Fee online.