Online Pre-Registration Form Child's Full Name*: Address, Town, Zip Code*: Home Phone: D.O.B.*: Mother: Father: Mother's Employer: Mother's Cell Phone: Father's Employer: Father's Cell Phone: Enrollment Desired (FULL DAYS ONLY - check only days desired): MondayTuesdayWednesdayThursdayFriday Approx. start date: Would you be interested in an earlier enrollment if a spot should open? YesNo At the time of registration, I agree to pay the non-refundable registration fee and first two weeks of tuition (if paying bi-weekly,) or the first month's tuition (if paying monthly,) plus a security fee. I understand that the security may not be applied to the last term of enrollment at Teddy Bear Corner. Should I withdraw my child prior to enrollment, I understand that I will forfeit the registration fee. Should I withdraw my child after enrollment without giving thirty (30) days written notice, I understand that I will forfeit all monies paid. (Security funds will be returned within 10 business days, minus any unpaid fees or penalties after your child's last day of the program.) Parent Name*: Parent Email*: Date*: