School Year 2026-2027 Enrollment Information

Child Information

Child's Name (First and Last) * Gender *

Male Female

Date of Birth * Age * Siblings (Names and Grades/Ages) Allergy/Special Dietary Needs *

Parent / Guardian Information

Parent / Guardian 1 Name *

Street Address * City * State * Zip Code *

Primary Phone * Secondary Phone Email Address * Marital Status * Step-parent's Name

Parent / Guardian 2 Information

Parent / Guardian 2 Name *

Street Address * City * State * Zip Code *

Primary Phone Secondary Phone Email Address Marital Status Step-parent's Name

Communication Information

In order to increase efficiency in communications and billing MCCC utilizes the Procare school information system app. Please provide your preferred email address so we may provide you with a link. Your email address will not be shared with anyone without your permission. If you provided more than one, please indicate your preferred email address below.

Preferred Email Address *

Madison Christian Children's Center