Mom's Day Out Ongoing Registration

Mom's Day Out Online Registration for ONGOING Registrations

IMPORTANT NOTE: If you have not received confirmation back from Mom's Day Out that your child is initially registered, you may NOT use this form. This form is only for confirmed registrations. Thank you!

Registration Deadline: MDO registrations forms must be turned in the first week of every month prior to the month of registration. For example: November registration forms are due the first week in October.

Payment Information: MDO payments for the current month will be due the first day your child attends during that month. For example: Payment for the month of November is due the first day your child attends in November.

Remember to please drop off your payment (checks made out to Mom's Day Out) at the same time you drop off your child. We regret that we are unable to take credit/debit cards at this time.

Use the form below to register - if you have more than one child in the Mom's Day Out program, once you submit your first child's registration, you will have an opportunity to register another child in a separate room.

If you have questions regarding this form, E-mail Patti Clauson, MDO Director.

Registration for the month of:

Please register for each child (unless they are twins)

Child's Full Name:

Class Child Will Attend: (for rooms starting at Gentle Giraffes, child must be completely potty trained)

Other Siblings in MDO (names):

Other Siblings' Class(es): (select more than one class by pressing SHIFT and click on the appropriate class)

Please indicate which days you plan to register your child for this month:

Parent(s)' Full Name(s):

Phone Number:

Once you have received your confirmation sheet confirming the dates you have registered for, NO CHANGES CAN BE MADE for this month!

Please make any special notations in the "Special Requests" space provided below (for example, if there will be a regular date you will miss or if you are requesting additional dates you do not typically attend). Please remember, you are only guaranteed your regular days. Other days will be given if available.

Special Requests: (if you have no special requests, please type in "none," thank you)

Rates:

1 Child: $18.00 per day
2 Children: $31.00 per day
3 Children: $38.00 per day

* If your child will be 3 years old as of September 1st, he/she must be potty trained (NO PULL-UPS PLEASE) to attend the Mom's Day Out Program.

Each field must be completed or you will receive an error message. If a field does not apply to you, then put "none" in the field.

Click on an animal below to visit your child's class!