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Childcare Waitlist

Parent/Guardian Info

Name(Required)

Child Info

Name of Child(Required)
MM slash DD slash YYYY
Individual needs:

Household Information

Blue Mountain Childcare participates in statewide programs that may assist eligible families with childcare tuition. The following household information is optional. Providing household information does not guarantee eligibility or enrollment in these programs. Information will be kept confidential and will help Blue Mountain Childcare determine what programs your family might be eligible for.