Children's Center and Nursery School Registration Form for Bard Employees

Bard Employees can use this form to register for the Nursery School and/or the Children's Center programs. Children must turn 3 by December 1 in the fall of their incoming year to attend the Children's Center and 4 by December 1 in the fall of their incoming year to attend the Nursery School.

You may submit this form anytime after the birth of your child.

Child's Name (First and Last)
Date of Birth Date of Birth / MM / DD YYYY
Incoming year (Fall)
Are you a full time Bard employee with benefits?

Are you a full time Bard employee with benefits? Yes No
Please describe your affiliation with Bard.
Parent/Guardian Contact Information

This is the primary contact for this child. There is space below to add a secondary contact.
Name (First and Last)
Home Phone Home Phone - ### - ### ####
Cell Phone Cell Phone - ### - ### ####
Email
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Preferred Method of Contact

Preferred Method of Contact Home Phone Cell Phone Email
Parent/Guardian Secondary Contact
Name (First and Last) Name (First and Last) First Last
Home Phone Home Phone - ### - ### ####
Cell Phone Cell Phone - ### - ### ####
Email
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Preferred Method of Contact

Preferred Method of Contact Home Phone Cell Phone Email
Program Selection
How many days per week would you like your child to attend?

How many days per week would you like your child to attend? 5 Days per Week 4 Days per Week 3 Days per Week
What time do you plan on picking up your child?

What time do you plan on picking up your child? 11:30am - Bard employee benefit time 12:45 pm - After lunch 4:00 pm - After Nap 4:00–5:15 pm - Extended Day

Children's Center and Nursery School Registration Form for Bard Employees

Children's Center and Nursery School Registration Form for Bard Employees

Parent/Guardian Contact Information

Parent/Guardian Secondary Contact

Program Selection