of Henderson - Las Vegas NV
1640 Patrick Lane, Henderson, NV 89014 (702) 547-3555

Pre-Registration Form

Space is limited in all age groups, so please take the time to pre-register your child using this on-line form. Pre-registration is not a commitment to attend or a promise of acceptance. Because enrollment is based on a first-come first-served basis, pre-registering will assist you in reserving a place for your child in his / her respective age group. Once your pre-registration has been submitted, you will be contacted regarding availability.

An * Denotes Required Field
Parent's Information
First Name* :
Last Name* :
Address :
City :
State :
Zip :
Phone* :
Phone Type:
Email* :
First Child's Information
First Name* :
Last Name* :
Gender (Male / Female)* :
Child's Birthday (mm/dd/yyyy)* :
Child's Care Schedule* :
Child's Start Date* :
Second Child's Information
First Name:
Last Name:
Gender (Male / Female):
Child's Birthday (mm/dd/yyyy):
Child's Care Schedule:
Child's Start Date:
Additional Comments, Questions or Special Needs...
Submit Pre-Registration
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