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Register Now Happy Hearts | (914) 271-0021 Take Two | (914)271-1009
Please submit a separate application for each child
Parent(s) Name(s)
Home Address
City
State
Zip
Home Phone Number
Email Address
Work Phone Number
Usual Work Hours
Name of Child
Date of Birth or Due Date
Name(s) of other child (ren) for whom an application is being submitted
Type of care requested Full-timePart-time
If part-time, days care is requested for are (specific part-time care will only be offered if space is available):
Date care is requested to begin:
(If space is available more than one month in advance of this date we will notify you.)
When enrollment is confirmed a Registration fee of $100, security deposit and the first month’s tuition is required to reserve a space for your child. This deposit is in the sum of one month’s tuition. The registration fee, deposit and the first month’s tuition is nonrefundable. The deposit may be applied provided a 30-day written notice. It will be deducted from the final month’s tuition at Happy Hearts.
Check for confirmation of this as an electronic signature
Please make your check payable to: Happy Hearts on the Hudson 10 Old Post Road South Croton on Hudson, NY Thank you for your application
(914) 271-0021
