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Programs
Before & After School Program
Youth Recreation Program
Summer Recreation Program
Daycare Program
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Call Us 518-273-5922
Programs
Before & After School Program
Youth Recreation Program
Summer Recreation Program
Daycare Program
About Us
About
Our History
Contact
Make A Payment
Call Us 518-273-5922
Apply Today
Daycare Application Form
Applications are for infants – 3 years old
Child Information
Childs Name
*
Street Address
*
Address
City
*
Zip Code
*
Date of Birth
Month
MM
January
February
March
April
May
June
July
August
September
October
November
December
Day
DD
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02
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04
05
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07
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13
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Guardian Information
Parent/Guardian's Name
Cell #
*
Parent/Guardian's Home #
*
Parent/Guardian's Work #
*
Street Address
*
Address
City
*
Zip Code
*
Guardian Information
Parent/Guardian's Name
Cell #
Parent/Guardian's Home #
Parent/Guardian's Work #
Street Address
Address
City
Zip Code
Emergency Contact 1
Name
*
Cell #
*
Emergency Contact 2
Name
Cell #
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