Registration

Register Online

  • First Time Enrollment

  • Horray!

    We're so excited you have chosen to enroll your child in Mom's Day Out, and we know you are too! Before that can happen there are some forms we need you to complete and return to us. Please download and complete the forms below, and return them in person or by mail to:

    Mom's Day Out
    2223 N. Mulford Rd.
    Rockford, IL 61107


    You will hear about your child’s placement within the next couple weeks once the forms are received.



    Forms:


    • Registration Forms Packet
    • Vaccination Forms
      A copy of your child’s vaccination records will be required at the time of registering.
    • First Time Students
      Must also attach the processing fee of $40 (non-refundable) per child made payable to Moms Day Out with their forms.


    Once you receive confirmation of your child's enrollment, you will be able to use the form below for ongoing monthly registration.
  • Ongoing Registration Form

  • Please register each child separately unless they are twins
  • For rooms starting with Giraffe, child must be completely potty trained
  • Please indicate which days you plan to register your child for this month.
  • If you would like to provide both parents' names, please use both Parent Name fields. At least one parent name is required. If only one parent name provided, leave Parent 2 Name fields blank.
  • Please make any special notations in the "Special Requests" space provided above (for example, if there will be a regular date you will miss or if you are requesting additional dates you do not typically attend). Please remember, you are only guaranteed your regular days. Other days will be given, if available.