Registration Form Parent Name * First Name Last Name Cell * (###) ### #### Work (###) ### #### Email * Preferred Contact Method * Cell Phone Work Phone Email Child's Name * First Name Last Name Child's Birthday/Estimated Birth Date * MM DD YYYY Additional Child's Name First Name Last Name Additional Child's Birthday/Estimated Birth Date MM DD YYYY Additional Child's Name First Name Last Name Additional Child's Birthday/Estimated Birth Date MM DD YYYY Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Preferred Language Ideal Enrollment Date * MM DD YYYY Agreement * • The “ideal enrollment date” is not a guarantee. Actual enrollment is based on a first come, first serve basis, with the exceptions of: 1) emergency situations, 2) families utilizing vouchers/scholarships, or 3) families currently enrolled at HWCEC. • There is a $100 registration fee per family due with the Registration/Wait List Contract. The registration fee is non-refundable. • Placement on the wait list only occurs with a completed Registration/Wait List Contract and full registration payment. • HWCEC has 9 wait lists based on age groups (example: 6-12 months, 12-18 months, 18 months – 2 years, 3-4 years, 4-5 years). As children become older, they will automatically move to the appropriate wait list. The Contract will be placed in Contract signed date order within each wait list. • As a vacancy becomes open, the Enrollment Coordinator will call the first family on the wait list within the appropriate age group. A family will have 24-hours to return the call after which time, we will continue calls down the wait list. I agree Parent Orientation * • Once a confirmed enrollment date has been established, there is a mandated parent orientation to review pertinent center information and completed enrollment paperwork. • I agree to follow all HWCEC policies and procedures outlined in the Parent Handbook. • The execution of a Sex Offender Certification Statement is a prerequisite to the enrollment process. Additionally, parents will be required to provide a valid U.S. government issued identification card (driver’s license or state ID) to scan through the National Sex Offender database. I agree Agreement * By submitting, I agree to the terms of the Registration/Wait List Contract. Additionally, I confirm that no enrollment date has been provided or guaranteed. I agree Signature * Thank you for registering!
