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Kim's Kids Family Child Care
Waiting List
If you would like to add your name to my waiting list, please fill out the form below and submit.  I would enjoy working with you and your family during the early childhood years.
Items marked with a red (*) are required fields.
* Parent's First Name
* Parent's Last Name 
* Address  
* City, State, ZIP Code
* Phone Number  
* Email Address  
* Child's Full Name
* Child's Birthday
* Desired Enrollment Date
* Days Needed
* Hours Needed
Child's Full Name (2nd)
Child's Date of Birth
Additional Comments
Copyright 2006 - Kim's Kids FCC - All Rights Reserved