Enroll Your Child

Today’s Kids are Tomorrows Future!

Our waiting list is open for fall registration

Please provide the required information below in the Admission Form below. This form serves as your child's enrollment application at Caterpillar Clubhouse Child Care Center.

Child's Information
Child's Name*
First Last
Age*
Sex*
- Male
- Female
Parent/Guardian's Information
Parent/Guardian's Name*
First Last
Address
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Person to contact in case of an emergency
Emergency Contact Name*
First Last
Emergency Contact Address
Street Address Address Line 2 City State ZIP Code
Health Information
Name of child's doctor*
Phone
Hospital Preference
Please list down any allergies or dietary restrictions for your child
Additional Information

Caterpillar Clubhouse

Enroll Your Child

Today’s Kids are Tomorrows Future!

Our waiting list is open for fall registration

Child's Information

Parent/Guardian's Information

Person to contact in case of an emergency

Health Information