Titusville YMCA
Tiny Footsteps Pre-K Readiness
School Year Hours: 7:30 AM - 6:00 PM
Summer Hours: 7:30 AM - 5:00 PM
Sign in to Google to save your progress. Learn more
Program Fees
Full Day - Child attends for 5 or more hours per day
Non-Member: $30.00/day
Member: $25.00/day

Half Day - Child attends less than 5 hours per day
Non-Member: $25.00/day
Member: $20.00/day

*Multiple Child Discount - Program fees for the youngest child of the family will be calculated at full rate. The oldest sibling will receive a 10% discount off their rate (as long as they attend the same number of days per week).

The Titusville YMCA participates in the PA Subsidized Child Care Program (CCIS).
E-mail Questions to: sroberts@worldconnx.net
Is your child a Titusville YMCA member? *
Child's Information
Child's First, Middle Initial, and Last Name *
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Age *
Child's Gender
Is your child enrolled at the ECLC? *
If enrolled at the ECLC, is he/she enrolled in the morning or afternoon?
Clear selection
Does your child have an IEP? *
Are you willing to share his/her IEP with us? *
Student resides with: *
Both Parents
Mother Only
Father only
Mother/ Stepfather
Father/ Stepmother
Grandparents
Foster Parent
Other
(Check one)
Who has custody?
Does parent/guardian have court ordered custody papers? (Note: The Y may require a copy of court orders) *
Attendance
My Child will attend:
Monday
Tuesday
Wednesday
Thursday
Friday
Check all that apply
Arrival time we can expect your child:
Time
:
Pick-up time:
Time
:
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy