Child Care Sign Up

Please complete the following form and click Submit. We will contact you as soon as possible regarding your request.

First Name *
Last Name *
Street Address
Zip Code
Contact Phone
E-mail Address
What is the best day and time to contact you?
How do you wish to be contacted?
Number of children needing care
Age of Child #1
Age of Child #2
Age of Child #3

Hours of care needed per week
Child #1 Hours
Child #2 Hours
Child #3 Hours

Date care is needed
Child #1 Date
Child #2 Date
Child #3 Date
Additional Comments

* Required to submit this form

Wee Care Day Care Center & Nursery School
Hours: Monday to Friday  6:30 a.m. to 5:30 p.m.
Phone: (860) 649-6167 Fax: (860) 646-3123
726 North Main Street, Manchester, CT 06040

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