adminassist@carelot.net
860-739-1993

Enroll

Please submit this form in order to be contacted by a Carelot Staff member to complete the enrollment process. Receipt of this form alone does not confirm enrollment in our programs.


Preferred Center*:
Child Name*:
Child DOB*:
Address:
Email:
Home Phone:
Guardian 1:  
Name*:
Work Phone: Cell Phone:
Guardian 2:  
Name:
Work Phone: Cell Phone:
Days of Week*:
Arrival Time:
Departure Time:
Begin Date: