UWRF-SA-Enrollment Request

Child Information

Full Name

Gender

Male

Female

Date of Birth

Infant (6 wks - 2 yrs)

Toddler (2 - 3½ yrs)

Pre-School (3½ - 5 yrs)

School Age (Summer Only)

Parent or Guardian Information

Name

Phone

Email Address

Enrollment Request Information

Enrollment Fee Status*

Planned Child-Care Enrollment Agreement**

Expected Enrollment Date

* You must be registered for 6 or more credits at UWRF each term to qualify for student rates.

**Agreements are defined as follows

A weekly agreement is defined as five-week days, full time care. Full-time is the only enrollment option for infants of community members.
A daily agreement is defined as 2 (T,Th) or 3 (M,W,F) days a week. Daily agreements for infants are available to students and faculty/staff only.
A half day agreement is defined as 7:00am-12:00pm.

Note: Completing this form does not guarantee your enrollment at the CHILD Center

There is a non-refundable $40.00 registration fee per UWRF student family. There is a non-refundable $75.00 registration fee per community/faculty/staff family. This is due at the time of enrollment. It is a one time fee as long as the child is continuously enrolled.

View Fees