Mercy Baptist Church

Child Development Center

Welcome

At the heart of Mercy Baptist Church CDC is a passion to love children well, introduce them to Jesus, and provide affordable childcare for families in our community. If you are interested in enrolling one of your blessings feel free to give us a call or you can fill out the form below and we will contact you. God Bless!!!

Mercy Baptist CDC Inquiry

Family Information

First Name

Last Name

Phone Number

First Name

Last Name

Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Child Information

First Name

Last Name

Birthdate

Potty Trained

Yes

In Progress

Previous Child Care

Medical Information

Allergies

Medical Conditions/Special Needs:

Care Requested

Desired Start Date

Tour Request

Would you like a tour?

Yes

Preferred Date/Time:

Waitlist Request

If no openings are available, place my child on the waitlist.

Yes

Emergency Contacts

First Name

Last Name

Phone Number

Relationship

First Name

Last Name

Phone Number

Relationship

Parent Acknowledgement

I understand that submitting this application does not guarantee enrollment. Enrollment is based on classroom availability, required documentation, and approval by Mercy Baptist CDC

Signature

Date Input

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Child Development Center

Welcome

Mercy Baptist CDC Inquiry

Family Information

Child Information

Medical Information

Care Requested

Tour Request

Waitlist Request

Emergency Contacts

Parent Acknowledgement

How To Contact Us

We'd love to hear from you. Fill out the form below to get started.

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