09/25/2021
(240)-453-9790
(301)-801-2100

Wait List Form
Daycare «Lyceum for Kids»

If our Daycare is currently full, please provide your information below, and we will contact you as soon as we have an opening for your child.

*Parent/Guardian Name: First:
Last:
*e-Mail Address:
Telephone(s):
Home:
Mobile:
Work:
Alternative e-Mail:
*Child's Full Name:
*Date of Birth (mm/dd/yyyy):
Childcare Locations:
(Check any of which you would like to attend. If more than one, indicate the preferred one in Comments)







Attendance Start Date:
(mm/dd/yyyy):
Attendance Schedule:
(describe):
Comments: