Register — Little Leaders of Garden City Kansas

Register Your Child Now!

Pease fill out the form below and someone from Little Leaders will be in contact with you to complete your registration.

If you would like to book a tour of our facility, please call us at (620) 275-5757.

Child's Name

First Name

Last Name

Child's Nickname (if applicable)

Child's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Child's Date of Birth

Child's Gender

Child's Phone #

(###)

###

####

Program To Attend

Traditional Daycare

Before & After School

Drop-In

Date Night

Summer Camp

Desired Start Date

YYYY

Doctor's Name & Phone #

Parent's Name

First Name

Last Name

Parent's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent's Phone

(###)

###

####

Do we have permission to send text messages to the above phone number?

Yes

Parent's Email

Parent's Place of Employment

Marital Status

Other Individuals Authorized To Pick Up Your Child

Please list full name, address, relationship, and phone number

Individuals who MAY NOT pick up your child

Please list name and relationship

Special information you’d like Little Leaders of GCK Early Learning Center to know