Child Care Network Enrollment Inquiry

Thank you for your interest in YMCA Child Care--we'd love to have you! Please tell us about your little one and your needs in the form below. A program director will get back to you to let you know the availability for the classroom you need.

Child's First & Last Name *

Child's Date of Birth *

Month

Day

Year

Type of Care *

Infant-30 Months

Toddler 31 Months-3 Years

Preschool-Age 3 & 4-year-olds

Parent's First/Last Name *

Phone Number *

Email *

Zip Code *

Desired Start Date *

Month

Day

Year

Has your child had previous experience attending child care? If yes, was it in home or center based care? *

Any behavioral concerns or special needs? *

How did you hear about us?

Additional Comments (From parents)

Leave this field blank

YMCA of Greater Michiana

Child Care Network Enrollment Inquiry

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