Big Top Child Care Center
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Center Ring Summer Registration Form
Please print this form. Complete the information requested and mail with deposit fee to: The Big Top Child Care Center
225 Brock Bridge Road
Laurel, MD 20724-2263

Child/ren's Name(s)

Birthdate(s)

Grade Entering Sept 2006
        
        
        
Parent(s) or Guardian(s), please print names, addresses, and both business and home phone numbers of parent(s) or guardian(s):
Mother's Info: Father's Info:

Name:

Name:
Address:
 Address:
Home Phone: Home Phone:
Work Pnone: Work Phone:
Email: Email:
Camp Weeks: Initial next to each week you would like your child to attend

Summer 2008
June 16-20 ________   July 21-25 ________
June 23-27 ________   July 28-Aug 1 ________
June 30-July 3 ________   Aug 4-8 ________
July 7-11 ________   Aug 11-15 ________
July 14-18 ________   Aug 18-22 ________
Fees: The camp fee is $190.00 for each week for each child. Please print this application, fill it out and either mail or bring to the front counter with your deposit fee. Make checks payable to: The Big Top Child Care. Include your deposit check for $10 for each week for each child who will attend.

Waiting list priorities will be established by date of receipt of this application.