Interested in Early Learning?

Interested in sending your child to the Y? Please fill out the form below to be added to our waitlist. Children aged 6 weeks through six years of age (or before kindergarten) will be accepted as space allows. All registration forms and fees must be received and reviewed by the Early learning Director before your child’s care begins.

Parent/Guardian

Address

City/Town

State/Province

ZIP/Postal Code

Contact Phone Number

Contact Email

Child's First Name

Child's Last Name

Child's Birthdate or Due Date

Which location are you looking for care? CHECK ONLY ONE BOX PLEASE

Barkley

Downtown

Heart House

Are you looking for full-time or part-time care?

Full Time

Part Time

Do you qualify for DSHS Assistance

Yes

Unsure

Desired Schedule

Estimated Start Date

Early learning Waitlist

Interested in Early Learning?