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39 Erie Street
Jersey City, NJ 07302

201-659-2211

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Drop-Off-Toddler Program Registration
 
 
 
DOTP Registration
* Required
First Name *
Last Name *
 
Email Address (For example: name@company.com)
 
Address Line 1 *
Address Line 2
City *
State *
Zip Code *
 
  Area Code Phone Number  
Home Phone *
  
Mobile Phone
  
Work Phone
 Ext 
 
 
Child's First Name *
 
Date of Birth *
 
Sex of Child *
Male
Female
 
Are you a member of Grace Church? *
Yes
No
 
PLEASE SUPPLY IN A LABELED BAG: - Plastic Drinking Cup - Diapers & Wipes - Pacifiers, if necessary - Change of Clothes - Bottle(s) of Milk with instructions - Healthy Snacks for your child We ask that you encourage your child to keep his/her own toys at home.
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SCHEDULE OF SERVICES

Sundays-11:00 AM

 
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