Registration

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There is a $25.00 Registration Fee

Print a Registration Form and mail it to us.

You will need PDF Reader to open the form.

OR
Use the online form below, and mail or come by with your payment.
All of the fields marked with a red asterisk * are required entry. Thank you!

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* Students Name :

Age :

* Birth Date :

* Parents Name :

* Address :

* City :

* State :

* Zip Code :

* Phone Number :

Heard about us from :

Web Site Billboard Newspaper Yellow Pages A Friend

Friend's Name :

Your E-Mail Address :

Comments :

After you push the SUBMIT button below, it will take about one half minute to process the form. Please be patient, you will return to our Home page when it has finished.

  

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Carolina After School Care, Inc.
2353 Concord Lake Road, Suite 120
Concord, NC 28025
Phone: 704-723-9858