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Apply to Lilyfrog
Child's First name
*
Child's Last name
*
Child's Birthday
*
Month
Child's Gender
Allergies/ Medical Conditions/ Things Lily Frog should know
Address
Parent/Guardian First Name
*
Parent/Guardian Last Name
*
Relationship to Child
*
Email
*
Phone
*
2- Parent/Guardian First Name
2- Parent\Guardian Last Name
Relationship to Child
Email
Phone
Desired Start Date
*
Desired Schedule
*
Full Week
Two Day (Tuesday, Thursday)
Three Day (Monday, Wednesday, Friday)
Early Morning Care (pre-school only)
Sibling Attending?
*
Yes
No
(If Yes) Sibling Name
Are you a military family?
*
Yes
No
How did you hear about us?
*
Internet Search
Friends and Family
Social Media
Road-side Sign
Newport This Week
Portsmouth or Sakonnet Times
Aquidneck Island Living Magazine
Other (please specify)
Date of application
Month
Signature
Clear
Application Fee
*
Test Fee
$1
Submit
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