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Registration and Enrollment Form

Thank you for your interest in enrolling with WINGS Child Care. We are committed to living up to the important responsibility of caring for your child.

To register and enroll, please submit this completed form and send or drop off your registration and enrollment fees to 717 Apollo Drive, Joliet, Illinois 60435. We accept cash, checks, and money orders. Please make checks payable to WINGS.

New Registrants:

Prior to enrollment, we wish to schedule a time for you to meet with us and learn about our services.

When your registration and enrollment form is received, you will be contacted regarding the availability of openings. When an opening is offered to you, in order to reserve that slot for your child, a tuition payment of one weekly rate will be due prior to the first day of attendance.

Days & Hours of Operation: M-F 6am-12midnight What days do you need child care? Enter the Time then select am or pm for Each Day. Example: Enter 6:00 in any box then select am or pm.
MON	-
TUE	-
WED	-
THU	-
FRI	-

Are you receiving subsidize funding for child care?
Yes (Esitmate co-pay/month: $)
No

Child / Children Information:

Enter 1st child here.
Child's Name: Fee: $50.
Age: Date of Birth: / /

Child's Name: Fee: $85.
Age: Date of Birth: / /

Child's Name: Fee: $120.
Age: Date of Birth: / /

Child's Name:
Age: Date of Birth: / /

Parent/Guardian Information:
ALL information in this section is required.

Name:

Relationship:

Address:

City: State:

Zip:

Email:

Home Phone: Example 8159991212

Cell Phone: Example 8159991212

Work Phone: Example 8159991212

What date would you like enrollment to begin? / /

We will do everything possible to meet your needs, but we are unable to guarantee start dates. Enrollment is based upon availability and is subject to the priority enrollment rules.

How did you hear about WINGS Child Care?