Inquiry Form

Space Availability Inquiry Form
Please fill out completely and submit to Creative Play Centers

NOTICE: Completion and submission of this form does not register your child(ren). This is for internal planning purposes for Creative Play Centers. Acceptance depends on space availability in the various centers at Adventure Clubs Creative Play Centers. If inquiring for more than one child, submit a separate form for each child.

Child's Name	Age		DOB
Address	City		Zip
Home Phone	eMail Address
Mother		Business Phone
Father		Business Phone
*How Did You Hear About Our Care Center?*
*Many Children For Care?* *Preferred Location For This Child*

Put an "X" on every day you need chilccare.

Full Days	M	TU	W	TH	F
Pre-School Only	M	TU	W	TH	F
Before School Only	M	TU	W	TH	F
After School Only	M	TU	W	TH	F
Kindergarten	M	TU	W	TH	F
Before & After School	M	TU	W	TH	F

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